Name the pulmonary imbalance using the following Arterial blood Gas (ABG) values: pH 7.41, PaCO2 46, HCO3- 30

Fully Compensated Metabolic Acidosis

Fully Compensated Respiratory Acidosis

Fully Compensated Respiratory Alkalosis

Fully Compensated Metabolic Alkalosis

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is B

Explanation

Choice A reason: Hydrochlorothiazide is for chronic hypertension, not acute pulmonary edema. Furosemide acts rapidly to relieve fluid overload, so this is incorrect for emergency use.

Choice B reason: Furosemide is the drug of choice for pulmonary edema, rapidly reducing fluid overload and relieving symptoms like frothy sputum. This is the correct choice.

Choice C reason: Mannitol is used for cerebral edema, not pulmonary edema. Furosemide targets acute fluid overload in the lungs, so this is incorrect for this scenario.

Choice D reason: Spironolactone is for chronic heart failure, not acute pulmonary edema. Furosemide’s rapid diuresis is needed, so this is incorrect for immediate treatment.

A. Intravenous theophylline, oxygen, and fluticasone [Flovent HFA] 220 mcg B. Four puffs of albuterol, oxygen, and intravenous theophylline C. Intravenous glucocorticoids, nebulized albuterol and ipratropium, and oxygen D. Intramuscular glucocorticoids and salmeterol by metered-dose inhaler

Correct Answer is C

Explanation

Choice A reason: Theophylline is rarely used due to toxicity risks and less efficacy compared to beta-agonists. Increasing fluticasone dose doesn’t address acute exacerbations, as inhaled corticosteroids act slowly. Oxygen is appropriate, but this regimen lacks rapid-acting bronchodilators, making it inadequate for acute asthma management.

Choice B reason: Four puffs of albuterol via inhaler may be insufficient for severe asthma (90% saturation, wheezes). Theophylline is outdated, and nebulized treatments are more effective in emergencies. Oxygen is needed, but this combination lacks systemic steroids for inflammation, making it less optimal.

Choice C reason: Intravenous glucocorticoids reduce airway inflammation rapidly, nebulized albuterol and ipratropium provide synergistic bronchodilation, and oxygen corrects hypoxia (90% saturation). This aligns with guidelines for acute asthma exacerbations, addressing inflammation, bronchoconstriction, and oxygenation, making it the correct and comprehensive treatment choice.

Choice D reason: Intramuscular glucocorticoids are slower than intravenous for acute asthma. Salmeterol, a long-acting beta-agonist, is inappropriate for acute exacerbations, as it lacks rapid onset. Oxygen is needed, but this regimen doesn’t address immediate bronchoconstriction effectively, making it incorrect for emergency management.

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Name the pulmonary imbalance using the following Arterial blood Gas (ABG) values: pH 7.41, PaCO2 46, HCO3- 30

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Correct Answer is B

Explanation

Correct Answer is C

Explanation

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