Ms. Jackson has been suffering from persistent vomiting for two days. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucous membranes and her capillary refill time takes more than 4 seconds. She is diagnosed with gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid base disorder is shown?
Metabolic Alkalosis, Partially Compensated
Respiratory Acidosis, Partially Compensated
Respiratory Alkalosis, Uncompensated
Metabolic Alkalosis, Uncompensated
The Correct Answer is D
Choice A reason: This choice is incorrect. Partial compensation would typically involve a change in PaCO2 to counterbalance the elevated bicarbonate, which is not observed here.
Choice B reason: This choice is incorrect. Respiratory acidosis is characterized by a low pH and an elevated PaCO2, which is not consistent with the given values.
Choice C reason: This choice is incorrect. Respiratory alkalosis would present with a low PaCO2 due to hyperventilation, which is not the case here.
Choice D reason: This is the correct choice. The elevated pH and HCO3 with a normal PaCO2 indicate metabolic alkalosis without respiratory compensation. Persistent vomiting can lead to loss of stomach acid, which causes metabolic alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Decreased blood pressure can be a sign of many conditions, including gastrointestinal perforation, but it is not specific and can occur in various other medical situations.
Choice B reason: Hyperactive bowel sounds are generally not associated with gastrointestinal perforation. They can occur in conditions like gastroenteritis or early bowel obstruction.
Choice C reason: Sudden abdominal pain, especially in the upper abdomen, can be a sign of gastrointestinal perforation. This pain is often severe and can be accompanied by signs of peritonitis.
Choice D reason: Tachycardia, or rapid heart rate, may occur as a compensatory mechanism in response to internal bleeding or infection, which can be secondary to gastrointestinal perforation.
Correct Answer is D
Explanation
Choice A reason: The prone position is not suitable for abdominal paracentesis as it does not allow access to the abdominal cavity.
Choice B reason: The lateral position is also not suitable as it can cause the fluid to shift, making it difficult to remove.
Choice C reason: While the supine position is commonly used for many medical procedures, it is not the best choice for abdominal paracentesis due to the distribution of fluid.
Choice D reason: The upright position is preferred because it allows the fluid to pool at the lowest point of the abdominal cavity, facilitating its removal.
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