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. Postoperative ileus and NG tube drainage are not typically associated with decreased calcium levels.
B. The nurse should monitor for electrolyte imbalances, particularly a decreased potassium level. This is because the gastrointestinal tract, especially the stomach, contains a high concentration of potassium, and substantial losses can occur with ongoing gastric suctioning.
C. NG tube drainage does not typically result in elevated sodium levels.
D. NG tube drainage does not typically result in elevated magnesium levels.
Correct Answer is B
Explanation
A. Elevated PaCO2 would be seen in respiratory acidosis, not metabolic acidosis.
B. Metabolic acidosis is characterized by a decreased pH.
C. This result would indicate metabolic alkalosis, not metabolic acidosis.
D. This result would indicate hypoxemia but is not specific to metabolic acidosis.
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