Anna's mother has been suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L.
What acid-base disorder is shown?
Respiratory Acidosis. Partially Compensated
Metabolic Alkalosis, Partially Compensated
Respiratory Alkalosis. Uncompensated
Metabolic Alkalosis, Uncompensated
The Correct Answer is B
A. Respiratory Acidosis, both compensated and uncompensated, is characterized by an elevated PaCO2, which is not present in this case.
B. The elevated pH (7.5) and HCO3 (34 mmol/L) indicate metabolic alkalosis. The elevated pH and the slightly elevated PaCO2 (40 mm Hg) suggest the partially compensated state, which is the respiratory compensation attempting to correct the alkalosis.
C. The fact that the PaCO2 is not low rules out respiratory alkalosis.
D. The arterial blood gas values indicate a high pH (7.5), a normal PaCO2 (40 mm Hg), and an elevated HCO3 (34 mmol/L), which are indicative of metabolic alkalosis. However, the elevated pH and the slightly elevated PaCO2 (40 mm Hg) suggest a partially compensated state.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Calcium supplements are not associated with peptic ulcer formation.
B. Flank pain can be a symptom of kidney stones, which can occur due to excessive calcium supplementation.
C. Pancreatitis is not typically associated with calcium supplementation.
D. Hepatitis is not typically associated with calcium supplementation.
Correct Answer is A
Explanation
A. Placing the client on seizure precautions is important as metabolic alkalosis can cause neurological symptoms, such as confusion and increased risk for seizures due to electrolyte imbalances (e.g., low calcium levels). Therefore, seizure precautions are warranted.
B. Breathing into a paper bag is used in respiratory alkalosis to increase CO2 levels, but it is not appropriate in metabolic alkalosis, where the issue is not primarily related to CO2 imbalance.
C. Encouraging the client to breathe slowly is generally more appropriate for respiratory alkalosis, not metabolic alkalosis. Slow breathing would not directly address the underlying issue of metabolic alkalosis.
D. Administering sodium bicarbonate would worsen metabolic alkalosis, as it would further increase the alkalotic state. Sodium bicarbonate is used in metabolic acidosis, not alkalosis.
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