The arterial blood gas below indicates that the primary acid-base imbalance is:
pH - 7.25
PaCO2 - 20 mm Hg
HCO3- - 10 mEq/L
Select all that apply:
Normal range:
pH = 7.35-7.45
PaCO2 = 36-44 mmHg
HCO3- = 22-26 mEq/L
Alkalosis
Respiratory
Metabolic
Acidosis
With compensation (being compensated)
The Correct Answer is C
Choice A: Alkalosis
Alkalosis refers to a condition where the blood pH is higher than the normal range (above 7.45). In this case, the pH is 7.25, which indicates an acidic environment rather than an alkaline one. Therefore, alkalosis is not the correct answer.
Choice B: Respiratory
Respiratory acidosis or alkalosis is determined by the levels of PaCO2. In respiratory acidosis, PaCO2 is elevated, while in respiratory alkalosis, PaCO2 is decreased. Here, the PaCO2 is 20 mm Hg, which is below the normal range, indicating a respiratory component. However, the primary issue is not respiratory because the HCO3- is also significantly low, pointing towards a metabolic cause.
Choice C: Metabolic
Metabolic acidosis is characterized by a low pH and a low HCO3- level. In this case, the pH is 7.25, and the HCO3- is 10 mEq/L, both of which are below the normal ranges. This indicates that the primary acid-base imbalance is metabolic acidosis.
Choice D: Acidosis
Acidosis refers to a condition where the blood pH is lower than the normal range (below 7.35). The given pH of 7.25 confirms that the patient is experiencing acidosis. However, this choice alone does not specify whether it is metabolic or respiratory acidosis.
Choice E: With Compensation (Being Compensated)
Compensation refers to the body’s attempt to return the pH to normal by adjusting the levels of PaCO2 or HCO3-. In this case, the low PaCO2 suggests that there is a respiratory compensation for the metabolic acidosis. However, the primary imbalance remains metabolic acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Oxygenation of the cells is a necessary process during reperfusion, but it is not the direct cause of reperfusion injury. The injury occurs due to the sudden influx of oxygen, which leads to the formation of reactive oxygen species (ROS) or free radicals. These free radicals cause oxidative stress and damage to the myocardial cells.
Choice B Reason:
Free radical formation is the primary mechanism behind reperfusion injury. When blood flow is restored to the ischemic myocardium, the sudden reintroduction of oxygen leads to the production of free radicals. These free radicals cause significant oxidative damage to the cell membranes, proteins, and DNA, exacerbating the injury to the heart tissue.
Choice C Reason:
An increased metabolic state can occur during reperfusion as the cells attempt to recover from ischemia. However, it is not the direct cause of reperfusion injury. The primary issue is the oxidative stress caused by free radicals, not the metabolic changes themselves.
Choice D Reason:
Lactic acid build-up is a consequence of anaerobic metabolism during the ischemic period, not a cause of reperfusion injury. During ischemia, cells switch to anaerobic metabolism, leading to lactic acid accumulation. However, once oxygen is reintroduced, the focus shifts to the oxidative damage caused by free radicals rather than lactic acid.
Correct Answer is B
Explanation
Choice A Reason:
Vomiting is not a risk factor for a heart attack but rather a symptom that can occur during a heart attack. Risk factors are conditions or behaviors that increase the likelihood of developing a disease. Vomiting can be a sign of various conditions, including gastrointestinal issues or even a heart attack, but it does not contribute to the risk of having a heart attack.
Choice B Reason:
Hypertension, or high blood pressure, is a significant risk factor for heart attacks. It causes the heart to work harder than normal, leading to the thickening of the heart muscle and narrowing of the arteries. Over time, this increased workload can damage the arteries, making them more susceptible to blockages that can cause a heart attack. Managing blood pressure through lifestyle changes and medication is crucial in reducing the risk of heart attacks.
Choice C Reason:
Chest pain is a common symptom of a heart attack but not a risk factor. Risk factors are pre-existing conditions or behaviors that increase the likelihood of developing a disease. Chest pain, also known as angina, occurs when there is reduced blood flow to the heart muscle, often due to blockages in the coronary arteries. While chest pain indicates a potential heart problem, it is not a contributing factor to the development of a heart attack.
Choice D Reason:
Cell necrosis refers to the death of cells, which can occur during a heart attack when the blood supply to part of the heart muscle is blocked. This is a consequence of a heart attack rather than a risk factor. Risk factors are conditions or behaviors that increase the likelihood of developing a disease, whereas cell necrosis is a result of the disease process.
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