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

Choice A Reason:

Tertiary prevention focuses on managing and mitigating the complications of an existing disease to prevent further deterioration. For obesity, this might involve interventions like bariatric surgery or intensive management of comorbid conditions such as diabetes or cardiovascular disease. In this scenario, the goal is not to prevent the onset of disease but to manage its long-term effects and improve quality of life.

Choice B Reason:

Disease treatment refers to the direct management of a diagnosed condition. For a diabetic teen, this could include medications like insulin or metformin, regular monitoring of blood glucose levels, and other medical interventions to control diabetes. While a low-calorie diet and exercise are important components of diabetes management, they are more aligned with preventive measures rather than direct treatment.

Choice C Reason:

Secondary prevention aims to detect and address a disease early in its course to prevent progression. This might include screening programs, early interventions, and lifestyle modifications for individuals at high risk of developing a condition. In the context of diabetes, secondary prevention could involve regular blood glucose monitoring and early dietary changes to prevent the progression from prediabetes to diabetes.

Choice D Reason:

Primary prevention involves measures taken to prevent the onset of a disease before it occurs. This includes lifestyle interventions such as a healthy diet, regular physical activity, and maintaining a healthy weight. For an obese diabetic teen, a prescription for a low-calorie diet and exercise program is aimed at preventing further weight gain and reducing the risk of developing additional health complications, making it a primary prevention strategy.

Choice A Reason:

Decreased ATP production is the primary cause of sodium and water accumulation in an injured cell. ATP is essential for the function of the sodium-potassium (Na±K+) pump, which maintains the ionic balance within the cell. When ATP levels drop, the Na±K+ pump fails, leading to an influx of sodium and water into the cell, causing cellular swelling.

Choice B Reason:

Calcification of the cell refers to the abnormal deposition of calcium salts within the cell. While calcification can occur in injured cells, it is not directly responsible for sodium and water accumulation. Calcification is more related to chronic injury and cell death rather than acute cellular swelling.

Choice C Reason:

Ribosome detachment from the endoplasmic reticulum can occur due to cellular stress and injury, leading to reduced protein synthesis. However, this detachment is not the direct cause of sodium and water accumulation. The primary issue is the failure of the Na±K+ pump due to decreased ATP production.

Choice D Reason:

Dehydration refers to the loss of water from the body or cells. While dehydration can affect cellular function, it is not the cause of sodium and water accumulation in injured cells. The accumulation is primarily due to the failure of the Na±K+ pump, which is dependent on ATP.