Interpret the following ABG: pH 7.44, PaCo2 48mmHg, HCO3 30 Meq/L

normal ABG

metabolic acidosis

metabolic alkalosis

respiratory acidosis

Answer and Explanation

The Correct Answer is C

Rationale:
A. Normal ABG would have pH between 7.35–7.45, PaCO₂ between 35–45 mmHg, and HCO₃⁻ between 22–26 mEq/L. This ABG is not fully normal.
B. Metabolic acidosis is characterized by low pH and low HCO₃⁻, which is not the case here.
C. Metabolic alkalosis shows elevated HCO₃⁻ (30 mEq/L) and a near-normal but slightly alkalotic pH (7.44). The elevated PaCO₂ (48 mmHg) suggests partial respiratory compensation.
D. Respiratory acidosis would have a low pH and high PaCO₂, which doesn't match this ABG.

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Correct Answer is B

Explanation

Rationale:
A. Sodium bicarbonate may be used to correct acidosis, but oxygenation must be addressed first to prevent further deterioration.
B. The first priority is to improve oxygenation. Administering oxygen by mask or nasal cannula is the most immediate and effective way to increase PaO₂ and support respiratory function.
C. A paper bag is used for respiratory alkalosis, not acidosis—it would worsen hypoxemia.
D. Glucose and insulin are used for hyperkalemia, which is not the current priority.

A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate. B. Administer potassium gluconate 40 mEq orally. C. Restrict fluid intake. D. Obtain a 12-lead ECG.

Correct Answer is D

Explanation

Rationale:
A. An erythrocyte sedimentation rate (ESR) is used to detect inflammation but is not relevant in the immediate management of hyperkalemia.
B. Administering potassium would worsen the client's already elevated potassium level.
C. Restricting fluids is not an appropriate initial response for hyperkalemia and can increase the risk of complications.
D. A potassium level of 6.8 mEq/L is critically high and can cause life-threatening cardiac dysrhythmias. A 12-lead ECG is essential to assess for cardiac effects of hyperkalemia, such as peaked T waves or widened QRS complexes.

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Interpret the following ABG: pH 7.44, PaCo2 48mmHg, HCO3 30 Meq/L

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has just experienced a 90-second tonic-clonic seizure. The arterial blood gas values are pH 6.88, PaO2 50 mmHg PaCO2 60 mmHg, and HCO3 22mEq/L. Which action should the nurse take first?

Correct Answer is B

Explanation

A nurse is reviewing the laboratory values for a client who takes spironolactone and notes that the client's serum potassium level is 6.8 mEq/L. The nurse notifies the provider and anticipates that the provider will provide which of the following instructions?

Correct Answer is D

Explanation

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