Ms. Jackson has been suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having 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
A. Metabolic Alkalosis, Partially Compensated, is incorrect because there is no evidence of respiratory compensation (normal PaCO2).
B. Respiratory Acidosis, Partially Compensated, is incorrect because the pH is high, not low as would be expected in acidosis, and the PaCO2 is normal, not high.
C. Respiratory Alkalosis, Uncompensated, is incorrect because the primary problem is metabolic (high HCO3), not respiratory, and the PaCO2 is normal, not low as would be seen in respiratory alkalosis.
D. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. In this scenario, the pH is elevated (7.5) and the bicarbonate (HCO3) level is high (34 mmol/L), indicating alkalosis. Vomiting leads to loss of gastric acid (hydrochloric acid), causing metabolic alkalosis. The respiratory system has not yet compensated fully for the alkalosis, as indicated by the normal PaCO2 (40 mm Hg).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Infusing hypotonic fluids such as 0.45% sodium chloride can exacerbate hyponatremia in a client with SIADH by further diluting serum sodium levels.
B. Desmopressin acetate is a synthetic form of ADH and would exacerbate the symptoms of SIADH by increasing water reabsorption and further diluting serum sodium levels.
C. Increasing dietary sodium intake would not be appropriate for a client with SIADH, as it would contribute to further fluid retention and exacerbate hyponatremia.
D. Fluid restriction is a key component of managing SIADH to prevent further water retention and dilutional hyponatremia. Restricting fluid intake helps to normalize serum sodium levels by allowing excess water to be excreted.
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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