Which complication(s) may occur due to a spinal cord injury? (Select all that apply)

A. Opiate drugs cause respiratory acidosis by depressing the central nervous system, specifically the respiratory centers in the brainstem, leading to reduced ventilation and accumulation of carbon dioxide. This increases arterial PCO2, lowering blood pH. The patient’s exposure to opiates aligns with this mechanism, as it impairs the physiological need for adequate respiration, a key component of Maslow’s hierarchy.

B. Atelectasis results in respiratory acidosis due to collapsed alveoli, which reduces effective gas exchange and causes carbon dioxide retention. This elevates PCO2, decreasing pH. The patient’s condition of atelectasis directly contributes to hypoventilation, supporting this classification.

C. Hypoventilation leads to respiratory acidosis by decreasing alveolar ventilation, causing carbon dioxide buildup. Elevated PCO2 lowers blood pH. The patient’s hypoventilation directly correlates with this mechanism, as it disrupts the respiratory system’s ability to maintain acid-base balance.

D. Renal failure causes metabolic acidosis by impairing the kidneys’ ability to excrete hydrogen ions and reabsorb bicarbonate, leading to acid accumulation and reduced serum bicarbonate. This aligns with the patient’s renal failure, as it disrupts the renal regulation of acid-base homeostasis, a critical physiological need.

E. Airway obstruction results in respiratory acidosis by preventing adequate ventilation, leading to carbon dioxide retention and increased PCO2, which lowers pH. The patient’s airway obstruction directly causes this imbalance, impairing respiratory function.

F. Diarrhea causes metabolic acidosis due to excessive loss of bicarbonate-rich intestinal fluids, reducing serum bicarbonate and lowering pH. The patient’s diarrhea aligns with this mechanism, as it leads to a direct loss of base, disrupting acid-base equilibrium.

Choice A reason: The glycosylated hemoglobin (HbA1c) test does not measure erythrocyte count. It reflects glucose binding to hemoglobin, indicating average blood glucose over months, not red cell quantity, making this choice incorrect.

Choice B reason: HbA1c does not measure insulin production but reflects glucose levels bound to hemoglobin over 2-3 months. Insulin production is assessed by other tests, like C-peptide, making this choice incorrect.

Choice C reason: HbA1c does not directly measure diabetes medication effectiveness but provides a long-term glucose control average. Medication efficacy is inferred indirectly, making this choice incorrect for the test’s primary purpose.

Choice D reason: The HbA1c test measures average blood glucose over 2-3 months by assessing glucose bound to hemoglobin in red cells, reflecting long-term glycemic control, making this the correct choice.