Name the following Arterial Blood Gas (ABG) values: pH 7.31, PaCO2 44, HCO3- 12

Choice A reason: Metabolic acidosis has low pH and HCO3-. Normal pH (7.41) and high HCO3- (30) suggest alkalosis, not acidosis, so this is incorrect for the ABG values.

Choice B reason: Respiratory acidosis has high PaCO2 and low pH. Normal pH and high HCO3- indicate metabolic alkalosis, not respiratory acidosis, so this is incorrect.

Choice C reason: Respiratory alkalosis has low PaCO2 and high pH. High PaCO2 (46) and HCO3- rule this out, pointing to metabolic alkalosis, so this is incorrect.

Choice D reason: Normal pH (7.41), high PaCO2 (46), and high HCO3- (30) indicate metabolic alkalosis fully compensated by respiratory CO2 retention. This is correct.

Choice A reason: Drugs with a narrow therapeutic range, like digoxin, require plasma level monitoring to ensure concentrations remain within a safe and effective range. This prevents toxicity (e.g., arrhythmias) or subtherapeutic effects, as small dose changes can significantly alter blood levels, making monitoring critical for patient safety and efficacy.

Choice B reason: Intravenous administration does not inherently address the risks of a narrow therapeutic range. While it ensures rapid delivery, it increases toxicity risk due to immediate bioavailability. Monitoring plasma levels is more critical than the route to maintain safe and effective drug concentrations, making this choice less appropriate.

Choice C reason: Administering at intervals longer than the half-life may lead to subtherapeutic levels for drugs with a narrow therapeutic range, reducing efficacy. Consistent dosing and plasma level monitoring are needed to maintain steady-state concentrations within the therapeutic window, making this choice incorrect for managing such drugs.

Choice D reason: Teaching that maximum effects occur quickly is inaccurate for most narrow therapeutic range drugs, which often require steady-state concentrations over time. Without monitoring, toxicity or inefficacy risks increase. Patient education should focus on adherence and monitoring, not rapid effects, making this choice inappropriate.