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Interpret the ABG: pH 7.41, PaCO2 45mmHg. HCO3 26, PaO2 84 mmHg. SaO2 97%

A.

normal ABG

B.

respiratory acidosis

C.

metabolic alkalosis

D.

respiratory alkalosis

Answer and Explanation

The Correct Answer is A

Rationale:

A. pH 7.41: Normal range is 7.35–7.45. PaCO₂ 45 mm Hg: Normal range is 35–45 mm Hg. HCO₃⁻ 26 mEq/L: Normal range is 22–26 mEq/L. PaO₂ 84 mm Hg: Normal range is 80–100 mm Hg. SaO₂ 97%: Normal range is 95–100%. All values are within normal limits, indicating a balanced acid-base and oxygenation status.

B. pH 7.41: Normal range is 7.35–7.45. PaCO₂ 45 mm Hg: Normal range is 35–45 mm Hg. HCO₃⁻ 26 mEq/L: Normal range is 22–26 mEq/L. PaO₂ 84 mm Hg: Normal range is 80–100 mm Hg. SaO₂ 97%: Normal range is 95–100%. All values are within normal limits, indicating a balanced acid-base and oxygenation status.

C. pH 7.41: Normal range is 7.35–7.45. PaCO₂ 45 mm Hg: Normal range is 35–45 mm Hg. HCO₃⁻ 26 mEq/L: Normal range is 22–26 mEq/L. PaO₂ 84 mm Hg: Normal range is 80–100 mm Hg. SaO₂ 97%: Normal range is 95–100%. All values are within normal limits, indicating a balanced acid-base and oxygenation status.

D. pH 7.41: Normal range is 7.35–7.45. PaCO₂ 45 mm Hg: Normal range is 35–45 mm Hg. HCO₃⁻ 26 mEq/L: Normal range is 22–26 mEq/L. PaO₂ 84 mm Hg: Normal range is 80–100 mm Hg. SaO₂ 97%: Normal range is 95–100%. All values are within normal limits, indicating a balanced acid-base and oxygenation status.


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Related Questions

Correct Answer is A

Explanation

Rationale:
A. Diabetes insipidus can lead to profound dehydration due to excessive fluid loss. A urine specific gravity of 1.002 indicates very dilute urine, supporting the concern. This child is at immediate risk for hypovolemic shock, so the nurse should assess them first.
B. A pulse oximetry of 95% is within acceptable range for a child with asthma, suggesting no acute distress at this time.
C. Roseola with a fever of 39°C is expected; while monitoring is needed, it's not the highest priority.
D. Pain of 6/10 in sickle cell anemia is concerning and requires attention, but it is not as emergent as potential fluid imbalance in diabetes insipidus.

Correct Answer is D

Explanation

Rationale:

A. Circumoral numbness and tingling are typically associated with respiratory alkalosis, not acidosis.
B. Muscle flaccidity is more indicative of electrolyte imbalances or late-stage neurologic decline, but not a key early sign of respiratory acidosis.
C. Cool, clammy skin may occur with shock or hypoperfusion, but is not a hallmark sign of respiratory acidosis.
D. Decreased level of consciousness is a key manifestation of acute respiratory acidosis, as rising CO₂ levels depress the central nervous system, leading to confusion, lethargy, and eventually coma if untreated.

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