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. Placing the child on a low-sodium diet is not a priority action for managing Addison's disease. Sodium restriction may be necessary in some cases, but it's not the primary intervention.
B. Monitoring the child for fluid volume excess is not directly related to managing Addison's disease. Addison's disease often leads to hypovolemia due to decreased aldosterone secretion.
C. Discussing manifestations of hyperglycemia may not be directly relevant to Addison's disease, which primarily affects cortisol and aldosterone levels, not glucose metabolism.
D. Teaching the parents about cortical replacement therapy is crucial. Addison's disease results from adrenal insufficiency, and cortical replacement therapy, typically with glucocorticoids and mineralocorticoids, is the mainstay of treatment.
Correct Answer is C
Explanation
A. Vasopressin does not typically affect blood pressure significantly.
B. Vasopressin is not used to lower blood sugar levels; it is primarily used for water retention.
C. Vasopressin, also known as antidiuretic hormone (ADH), acts on the kidneys to decrease urine output, making this the expected outcome of therapy.
D. Specific gravity of urine may increase with vasopressin therapy due to decreased urine output, rather than decrease.
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