A patient's blood gases show a pH of 7.53 and bicarbonate level of 36 mEq/L. The nurse realizes that the patient is demonstrating which acid-base disorder?

Metabolic alkalosis.

Choice A rationale:

The given blood gas results show a pH of 7.53, which is alkaline (above the normal range of

7.35 to 7.45), and a high bicarbonate level of 36 mEq/L (normal range is 22 to 26 mEq/L). This combination indicates metabolic alkalosis, a condition where there is an excessive accumulation of bicarbonate in the blood, leading to increased pH.

Choice B rationale:

Metabolic alkalosis is characterized by increased blood bicarbonate levels, which can occur due to conditions like vomiting, diuretic use, or excessive ingestion of bicarbonate-containing substances. It results in symptoms such as muscle twitching, tetany, and respiratory depression.

Choice C rationale:

Respiratory alkalosis is characterized by an elevated blood pH and low carbon dioxide levels (hypocapnia). However, the bicarbonate level is not directly related to respiratory alkalosis, making this choice incorrect based on the given information.

Choice D rationale:

Metabolic acidosis is characterized by a decreased blood pH and low bicarbonate levels. The presented blood gas results show an alkaline pH and high bicarbonate, making this choice incorrect.

Urine specific gravity 1.020.

Choice A rationale:

Urine specific gravity is a measure of urine concentration, indicating the ability of the kidneys to concentrate or dilute urine. A specific gravity of 1.020 falls within the normal range (typically 1.010 to 1.030). An appropriate specific gravity indicates that the client's kidneys are responding well to the IV fluids, maintaining adequate urine output and concentration.

Choice B rationale:

Potassium level of 5.2 mEq/L is above the normal range of 3.5 to 5 mEq/L. However, this value does not specifically indicate whether the client is responding effectively to the IV fluids for dehydration.

Choice C rationale:

Hct (Hematocrit) of 6296 is not a valid measurement; it appears to be a typographical error or an incomplete value. Therefore, it cannot be used to assess the client's response to treatment.

Choice D rationale:

Sodium level of 165 mEq/L is elevated beyond the normal range of 136 to 145 mEq/L. However, this value does not provide information about the client's response to IV fluids for dehydration.