Maria, an elementary student, was rushed to the hospital due to vomiting and a decreased level of consciousness. The patient displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. He appears to be dehydrated-his eyes are sunken and mucous membranes are dry-and he has a two-week history of polydipsia, polyuria, and weight loss. Measurement of arterial blood gas shows pH 7.0, Pa02 90 mm Hg. PaCO2 23 mm Hg, and HCO3 12 mmol/L; other results are Na+ 126 mmol/L. K+ 5 mmol/L, and Cl-95 mmol/L.
What is your assessment?
Respiratory Acidosis, Partially Compensated
Metabolic Acidosis, Partially, Compensated
Metabolic Alkalosis. Uncompensated
Respiratory Acidosis, Uncompensated
The Correct Answer is B
A. This option can be ruled out because the pH and PaCO2 levels indicate acidosis, but the compensation is not partial as the HCO3 is also low.
B. Maria's symptoms and the arterial blood gas values support this diagnosis. Metabolic acidosis is indicated by a low pH and a decreased bicarbonate (HCO3) level. The body attempts to compensate for this acidosis by hyperventilating, which is evidenced by her Kussmaul breathing, to decrease PaCO2. This compensation is partial because, despite the body's efforts, the pH is still significantly lower than normal.
C. This option can be ruled out because the pH is low (acidosis) rather than high (alkalosis), and the HCO3 is low rather than high.
D. Respiratory Acidosis, Uncompensated is ruled out because the pH is low (acidosis), but the PaCO2 is normal, indicating metabolic rather than respiratory involvement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hyperkalemia is a common finding in the oliguric phase of acute kidney injury due to impaired renal function, leading to decreased potassium excretion.
B. Hypomagnesemia is not typically associated with the oliguric phase of acute kidney injury.
C. In the oliguric phase, the glomerular filtration rate is typically decreased, not increased.
D. In acute kidney injury, creatinine levels typically rise due to decreased renal function, rather than decrease.
Correct Answer is A
Explanation
A. Creatinine levels rise in acute kidney injury due to impaired kidney function, as the kidneys are unable to effectively filter creatinine from the blood.
B. BUN (blood urea nitrogen) levels typically increase in dehydration due to reduced kidney perfusion, leading to decreased urine output and increased concentration of waste products in the blood.
C. Specific gravity increases in hypovolemia because urine becomes more concentrated as the body tries to conserve water.
D. Potassium levels may vary depending on the cause of polyuria, but polyuria itself does not necessarily cause hyperkalemia. It can be caused by various factors including diabetes insipidus or diabetes mellitus.
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