Name the following arterial blood gas (ABG) values: pH 7.47, PaCO2 32, HCO3- 23

Choice A reason: Furosemide, a loop diuretic, promotes potassium excretion, risking hypokalemia. The patient’s potassium level (3.1 mEq/L) is below normal (3.5-5.0 mEq/L), indicating hypokalemia, which can cause arrhythmias. Administering Lasix without addressing this could worsen the electrolyte imbalance, making this choice unsafe and incorrect.

Choice B reason: Oxygen administration addresses respiratory issues, not electrolyte imbalances like hypokalemia (3.1 mEq/L) caused by furosemide. There’s no indication of hypoxia in the lab results or scenario. This action doesn’t correct the potassium deficit or prevent further depletion, making it irrelevant and incorrect.

Choice C reason: Furosemide exacerbates hypokalemia (patient’s potassium: 3.1 mEq/L), risking cardiac arrhythmias or muscle weakness. Holding the dose prevents further potassium loss, and notifying the physician allows for correction (e.g., potassium supplements) and reassessment of therapy, making this the safest and most appropriate action.

Choice D reason: A 24-hour urine collection assesses renal function or output but doesn’t address the immediate concern of hypokalemia (3.1 mEq/L) caused by furosemide. This test is irrelevant to correcting the electrolyte imbalance or preventing further depletion, making it an inappropriate action in this scenario.

Choice A reason: A 25-year-old man typically has mature liver and kidney function, efficiently metabolizing and excreting CNS depressants like benzodiazepines. Toxicity risk is lower compared to neonates, whose immature systems impair drug clearance, making this choice less critical for close toxicity monitoring.

Choice B reason: A 15-year-old boy has relatively mature metabolic pathways, though not fully adult-like. CNS depressants are cleared more effectively than in neonates, reducing toxicity risk. Adolescents are less vulnerable than infants to accumulation, making this choice less concerning for drug toxicity observation.

Choice C reason: A 3-week-old neonate has immature liver enzymes (e.g., CYP450) and reduced renal clearance, increasing the risk of CNS depressant toxicity (e.g., respiratory depression, sedation). Their low body mass and underdeveloped metabolism necessitate close monitoring, making this the correct choice for heightened toxicity vigilance.

Choice D reason: A 25-year-old woman, like men of the same age, typically has efficient drug metabolism and excretion. CNS depressants pose lower toxicity risk compared to neonates, whose immature systems lead to drug accumulation, making this choice less critical for close toxicity monitoring.