A nurse is reviewing the laboratory results of a client who was an unrestrained passenger in a motor-vehicle crash. The ABG results are as follows: pH 7.32, HCO3 24 mEq/L, PaCO2 48 mm Hg. The nurse should identify the client is experiencing which of the following acid-base imbalances?

Respiratory acidosis

Metabolic acidosis

Respiratory alkalosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is A

A) Respiratory acidosis: This condition is indicated by a low pH (7.32) and an elevated PaCO2 (48 mm Hg), while HCO3 remains normal (24 mEq/L). Respiratory acidosis occurs when there is an accumulation of carbon dioxide in the blood, usually due to hypoventilation or impaired gas exchange in the lungs.

B) Metabolic acidosis: Metabolic acidosis is characterized by a low pH and a decreased HCO3 level. In this scenario, the HCO3 level is normal, ruling out metabolic acidosis.

C) Respiratory alkalosis: Respiratory alkalosis is indicated by a high pH and a decreased PaCO2. In this case, the pH is low, and the PaCO2 is elevated, which contradicts the characteristics of respiratory alkalosis.

D) Metabolic alkalosis: Metabolic alkalosis would show a high pH and an elevated HCO3 level. Since the pH is low and the HCO3 is normal, this condition does not fit the criteria for metabolic alkalosis.

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Correct Answer is D

Explanation

A) Bounding peripheral pulses: Metabolic acidosis typically does not cause bounding peripheral pulses. In metabolic acidosis, vasodilation might occur, but it usually leads to weaker, not bounding, pulses due to decreased cardiac output and blood pressure.

B) Hyperreflexia: Hyperreflexia is not commonly associated with metabolic acidosis. Instead, metabolic acidosis may cause symptoms like muscle weakness or fatigue due to the effect of acid-base imbalance on neuromuscular function.

C) Cool skin: While cool skin can sometimes be associated with poor perfusion in severe cases, it is not a direct manifestation of metabolic acidosis. Metabolic acidosis more commonly affects internal physiology rather than peripheral skin temperature directly.

D) Hypotension: Hypotension is a common manifestation of metabolic acidosis. The acidosis leads to vasodilation and decreased cardiac contractility, resulting in a drop in blood pressure. This is a critical sign for the nurse to monitor as it indicates the severity of the acid-base imbalance and its effect on the cardiovascular system.

A. Apples B. Potatoes C. Tomatoes D. Bananas

Correct Answer is C

Explanation

A) Apples:
Apples are generally considered safe for individuals with gastroesophageal reflux disease (GERD). They are low in acid and do not typically contribute to reflux symptoms, making them a suitable fruit choice.

B) Potatoes:
Potatoes are bland and non-acidic, making them a good option for individuals with GERD. They do not typically trigger reflux symptoms and can be included in a reflux-friendly diet.

C) Tomatoes:
Tomatoes are highly acidic and can significantly aggravate GERD symptoms. Their acidity can weaken the lower esophageal sphincter, allowing stomach acid to reflux into the esophagus, causing discomfort and heartburn.

D) Bananas:
Bananas are low in acid and often recommended for people with GERD. They are gentle on the stomach and do not usually cause reflux symptoms, making them a good dietary choice for managing GERD.

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A nurse is reviewing the laboratory results of a client who was an unrestrained passenger in a motor-vehicle crash. The ABG results are as follows: pH 7.32, HCO3 24 mEq/L, PaCO2 48 mm Hg. The nurse should identify the client is experiencing which of the following acid-base imbalances?

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