The nurse is caring for a client whose arterial blood gas reveals partially compensated respiratory alkalosis. Which results are consistent with this finding?

Table 9.9 Normal Arterial Blood Gas Values

ABG Value.                                                             Normal Value

pH                                                                             7.35-7.45

PaCO2                                                                                                            35-45 mmHg

HCO3-                                                                         22-26mEq/L

Base excess                                                               -2 to +2

PaO2                                                                            80-95 mmHg

SaO2                                                                            >95%

pH 7.32, Pa02 88 mmHg, PaCO2 50 mmHg, HCO3 29 mEq/L, 02 sat 94%

pH 7.35, Pa02 98 mmHg, PaCO2 55 mmHg, HCO3 28 mEq/L, 02 sat 99%

pH 7.64, PaO2 94 mmHg, PaCO2 23 mmHg, HCO3 14 mEq/L, 02 sat 88%

PH 7.50, Pa02 91 mmHg, PaCO2 52 mmHg, HCO3 30 mEq/L, 02 sat 96%

Answer and Explanation

The Correct Answer is C

A) pH 7.32, PaO2 88 mmHg, PaCO2 50 mmHg, HCO3 29 mEq/L, O2 sat 94%
This result suggests respiratory acidosis rather than respiratory alkalosis. In respiratory acidosis, the pH would be low (acidotic), PaCO2 would be elevated (since it reflects CO2 retention), and HCO3 would typically be elevated as a compensatory mechanism. This set of ABG values does not align with respiratory alkalosis, so it is not consistent with partially compensated respiratory alkalosis.

B) pH 7.35, PaO2 98 mmHg, PaCO2 55 mmHg, HCO3 28 mEq/L, O2 sat 99%
This set of values suggests respiratory acidosis, as indicated by a low pH (acidosis) and high PaCO2 (carbon dioxide retention). The HCO3 value is slightly elevated in compensation for respiratory acidosis, but this is not an example of partially compensated respiratory alkalosis, so it doesn't match the question's requirement.

C) pH 7.64, PaO2 94 mmHg, PaCO2 23 mmHg, HCO3 14 mEq/L, O2 sat 88%
This result is consistent with partially compensated respiratory alkalosis. In respiratory alkalosis, the pH would be elevated (alkalotic), PaCO2 would be low (indicating hyperventilation), and the kidneys would attempt to compensate by lowering bicarbonate (HCO3). In this case, the low PaCO2 (23 mmHg) and the low HCO3 (14 mEq/L) demonstrate partial compensation. The pH is also elevated at 7.64, which aligns with alkalosis. This is the correct answer for partially compensated respiratory alkalosis.

D) pH 7.50, PaO2 91 mmHg, PaCO2 52 mmHg, HCO3 30 mEq/L, O2 sat 96%
This result suggests respiratory acidosis with compensation. The elevated PaCO2 (52 mmHg) indicates CO2 retention, leading to acidosis, while the slightly elevated HCO3 (30 mEq/L) shows that the kidneys are compensating for the respiratory acidosis. The pH of 7.50 is slightly alkalotic, but it is more consistent with compensation for respiratory acidosis rather than respiratory alkalosis. Thus, this set of ABG values does not match the description of partially compensated respiratory alkalosis.

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Correct Answer is A

Explanation

A. Muscle rigidity and bradykinesia: Parkinson's disease (PD) is characterized by a combination of motor symptoms due to the degeneration of dopamine-producing neurons in the brain. The hallmark motor symptoms include muscle rigidity (stiffness of muscles, making movement difficult) and bradykinesia (slowness of movement). These symptoms are typically present early in the disease and can lead to difficulties with daily activities such as walking, speaking, and performing fine motor tasks. These two signs are primary indicators of Parkinson's disease.

B. Facial pain and ptosis: Facial pain and ptosis (drooping eyelids) are not typical symptoms of Parkinson's disease. PD can affect facial expression (resulting in a masked face), but it does not usually cause facial pain. Ptosis is more commonly seen in conditions like Horner's syndrome, myasthenia gravis, or as a side effect of medications, but it is not a hallmark symptom of Parkinson's disease.

C. Diarrhea and nausea: While gastrointestinal symptoms such as constipation can be seen in Parkinson's disease due to autonomic dysfunction and decreased gut motility, diarrhea and nausea are not typical primary symptoms. In fact, constipation is a more common issue in PD. Nausea could result from the use of medications like levodopa, but it is not a defining feature of the disease itself.

D. Ecchymosis and petechiae: Ecchymosis (bruising) and petechiae (small red or purple spots on the skin) are not characteristic of Parkinson's disease. These findings are more often associated with platelet disorders, bleeding disorders, or vascular conditions. While Parkinson's disease can involve complications like falls (which could lead to bruising), these are not direct symptoms of the disease itself. The primary symptoms involve motor and autonomic dysfunction.

A. pH 7,44; Pa02 44 mmHg: PaCO2 35 mmHg; HCO3 25 mEq/L; 02 Sat 76% B. pH 7.30; Pa02 80 mmHg; PaCO2 62 mmHg; HCO3 25 mEq/L; 02 Sat 94% C. pH 7.35; Pa02 65 mmHg; PaCO2 40 mmHg: HCO3 26 mEq/L; 02 Sat 90% D. PH 7.48; Pa02 75 mmHg; PaCO2 41 mmHg: HCO3 28 mEg/L; 02 Sat 9386

Correct Answer is A

Explanation

A. pH 7.44; PaO2 44 mmHg; PaCO2 35 mmHg; HCO3 25 mEq/L; O2 Sat 76%: This set of arterial blood gas (ABG) values is consistent with hypoxemic respiratory failure. Hypoxemic respiratory failure is characterized by a PaO2 less than 60 mmHg, and this client has a PaO2 of 44 mmHg, which is significantly below the normal range of 80-95 mmHg. Despite the fact that the client is on a 100% non-rebreather mask (which should ideally deliver high levels of oxygen), the low PaO2 suggests that oxygenation is not being effectively improved. Additionally, the low O2 saturation of 76% further supports the diagnosis of hypoxemic respiratory failure.

B. pH 7.30; PaO2 80 mmHg; PaCO2 62 mmHg; HCO3 25 mEq/L; O2 Sat 94%: This ABG indicates respiratory acidosis (pH is low, PaCO2 is elevated), but the PaO2 of 80 mmHg is within the normal range, and the O2 saturation of 94% is also normal. Respiratory acidosis with a normal PaO2 would indicate an issue with ventilation (hypoventilation), not hypoxemic respiratory failure. The patient is retaining CO2 but is still oxygenating well, so this result does not indicate hypoxemic respiratory failure.

C. pH 7.35; PaO2 65 mmHg; PaCO2 40 mmHg; HCO3 26 mEq/L; O2 Sat 90%: This result shows a PaO2 of 65 mmHg, which is mildly low but not sufficiently low to meet the criteria for hypoxemic respiratory failure (PaO2 should be below 60 mmHg for this diagnosis). The O2 saturation of 90% is also slightly low but not critically low. This client may have mild hypoxia but is not in respiratory failure based on these values.

D. pH 7.48; PaO2 75 mmHg; PaCO2 41 mmHg; HCO3 28 mEq/L; O2 Sat 93%: In this case, the PaO2 of 75 mmHg is slightly low but still within an acceptable range, and the O2 saturation of 93% is adequate. The elevated pH and normal PaCO2 suggest the presence of respiratory alkalosis (likely caused by hyperventilation). These ABG results are not consistent with hypoxemic respiratory failure, as the oxygen levels are still within a safe range.

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