Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?

pH = 7.46, PaCO2 = 44 mm Hg, PaO2 = 95 mm Hg, and HCO3 = 36 mEq/L.

pH = 7.27, PaCO2 = 70 mm Hg, PaO2 = 80 mm Hg, and HCO3 = 26 mEq/L.

pH = 7.30, PaCO2 = 35 mm Hg, PaO2 = 70 mm Hg, and HCO3 = 20 mEq/L.

pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.

Answer and Explanation

The Correct Answer is D

The correct answer is Choice D. Then start with Choice A rationale:

Choice A is incorrect because it represents metabolic alkalosis, not respiratory alkalosis. Metabolic alkalosis occurs when there is a primary increase in the bicarbonate (HCO3) level, which causes the pH to rise above the normal range (7.35-7.45). The PaCO2 is normal in this case, indicating that the respiratory system is not involved in the acid-base imbalance. Some causes of metabolic alkalosis include vomiting, diuretic use, excessive antacid intake, and mineralocorticoid excess 1.

Choice B is incorrect because it represents respiratory acidosis, not respiratory alkalosis. Respiratory acidosis occurs when there is a primary decrease in the PaCO2 level, which causes the pH to fall below the normal range. The HCO3 is normal in this case, indicating that the metabolic system is not involved in the acid-base imbalance. Some causes of respiratory acidosis include hypoventilation, airway obstruction, chest trauma, neuromuscular disorders, and chronic lung diseases 2.

Choice C is incorrect because it represents metabolic acidosis, not respiratory alkalosis. Metabolic acidosis occurs when there is a primary decrease in the HCO3 level, which causes the pH to fall below the normal range. The PaCO2 is normal in this case, indicating that the respiratory system is not involved in the acid-base imbalance. Some causes of metabolic acidosis include diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea, and poisoning 3.

Choice D is correct because it represents respiratory alkalosis. Respiratory alkalosis occurs when there is a primary decrease in the PaCO2 level, which causes the pH to rise above the normal range. The HCO3 is normal in this case, indicating that the metabolic system is not involved in the acid-base imbalance. Some causes of respiratory alkalosis include hyperventilation, anxiety, panic, fever, pain, tumor, trauma, severe anemia, liver disease, overdose of certain medicines, pulmonary embolism, pregnancy, and any lung disease that leads to shortness of breath . Respiratory alkalosis is characterized by symptoms such as breathlessness, dizziness, numbness, tingling, muscle spasms, chest discomfort, confusion, and fainting.

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Correct Answer is B

Explanation

The correct answer is: B. Normocytic.

Choice A rationale: Microcytic erythrocytes, or smaller-than-normal red blood cells, are typically seen in chronic conditions like iron deficiency anemia, not acute blood loss.

Choice B rationale: Normocytic erythrocytes, or normal-sized red blood cells, are usually seen in acute blood loss as the body's initial response doesn't alter the size of red blood cells.

Choice C rationale: Hypochromic erythrocytes, or paler-than-normal red blood cells, are more common in chronic anemia states such as iron deficiency.

Choice D rationale: Megaloblastic erythrocytes, or abnormally large red blood cells, are seen in conditions like vitamin B12 or folate deficiency, not in acute blood loss.

A. "Are you pregnant?” B. "Do you need to urinate?” C. "Do you have a headache or confusion?” D. "Are you taking antiseizure medications?”

Correct Answer is C

Explanation

Choice A rationale:

While pregnancy can contribute to increased blood pressure, it is not the priority question in this scenario. The sudden rise in blood pressure could indicate a hypertensive crisis, which needs immediate attention.

Choice B rationale:

Urination is not directly related to sudden rises in blood pressure. While urinary issues could be a sign of certain conditions, they are not the priority when dealing with a hypertensive emergency.

Choice C rationale:

A sudden rise in blood pressure can lead to symptoms such as headache and confusion, which could indicate a hypertensive crisis. This question is crucial to assess neurological symptoms, which can be indicative of target organ damage due to hypertension.

Choice D rationale:

Antiseizure medications are not directly related to sudden increases in blood pressure. Neurological symptoms (like those in choice C) are more indicative of a hypertensive crisis and require immediate attention.

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Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?

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