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 C
Explanation
A. Making a list of favorite beverages shows awareness but does not necessarily indicate an understanding of fluid restriction.
B. Putting beverages in large containers to deceive fluid intake is not a recommended or appropriate strategy for managing fluid restriction.
C. Not adding fluid-rich foods like ice cream to the total fluid intake demonstrates an understanding of fluid restriction and adherence to the prescribed limit.
D. Consuming most fluids during the evening is not an appropriate strategy for fluid restriction; fluid intake should be evenly distributed throughout the day.
Correct Answer is B
Explanation
A. Kernig's sign is a test for meningitis and is not related to the tingling sensation described by the client.
B. Chvostek's sign is a clinical sign of hypocalcemia, which can occur post-thyroidectomy due to inadvertent damage or removal of the parathyroid glands.
C. Babinski's sign is a test for upper motor neuron lesions and is not related to the tingling sensation described by the client.
D. Brudzinski's sign is a test for meningitis and is not related to the tingling sensation described by the client.
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