George Kent is a 54-year-old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L and Pa02 60 mm Hg.
How would you interpret this?
Metabolic Acidosis. Partially Compensated
Respiratory Acidosis, Uncompensated
Respiratory Acidosis, Partially Compensated
Metabolic Alkalosis Uncompensated
The Correct Answer is C
A. Metabolic acidosis would involve a low pH and low bicarbonate level, which is not evident in the given arterial blood gas results.
B. The low pH (acidosis) and high PaCO2 (respiratory component) indicate respiratory acidosis. The increased HCO3 (normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
C. George Kent's arterial blood gas values indicate a lower pH and an elevated PaCO2, which are consistent with respiratory acidosis. The increased HCO3 ((normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
D. Metabolic alkalosis is not supported by the given arterial blood gas results.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
A. Bicarbonate excess is not a clinical manifestation but rather the underlying cause of metabolic alkalosis.
B. Metabolic alkalosis can lead to potassium depletion, which may cause muscle weakness.
C. Kussmaul's respirations, characterized by deep and labored breathing, are more commonly associated with metabolic acidosis, not alkalosis, as the body tries to compensate for acidemia by expelling more carbon dioxide through deep breaths.
D. Alkalosis can cause peripheral vasodilation and decreased calcium ionization, leading to circumoral and digital paresthesia.
E. Alkalosis can cause cerebral vasoconstriction and decreased cerebral perfusion, leading to dizziness.
Correct Answer is D
Explanation
A. In primary hypothyroidism, the thyroid gland fails to produce sufficient thyroid hormone.
Consequently, free T4 levels are typically decreased.
B. Although serum T3 levels may also decrease in primary hypothyroidism due to impaired thyroid function, TSH is the primary marker used for diagnosis and monitoring.
C. Similarly, serum T4 levels may decrease in primary hypothyroidism due to decreased synthesis by the thyroid gland.
D. In primary hypothyroidism, the anterior pituitary gland releases more TSH to stimulate the thyroid gland to produce thyroid hormones. Therefore, elevated TSH levels are characteristic of primary hypothyroidism.
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