Exhibits

Complete the following sentence by choosing from the lists of options.

A pH level of and bicarbonate (HCO3-) level ofindicate a resolution of ketoacidosis.

pH 7.25 and HCO₃⁻ 18 mEq/L

pH 7.30 and HCO₃⁻ 20 mEq/L

pH 7.38 and HCO₃⁻ 24 mEq/L

pH 7.20 and HCO₃⁻ 15 mEq/L

Answer and Explanation

The Correct Answer is C

A. pH 7.25 and HCO₃⁻ 18 mEq/L. A pH of 7.25 is still acidotic, and a bicarbonate level of 18 mEq/L is below the normal range (22–26 mEq/L), indicating persistent metabolic acidosis. This suggests that ketoacidosis is not fully resolved, requiring continued insulin therapy, hydration, and electrolyte management.
B. pH 7.30 and HCO₃⁻ 20 mEq/L. While this shows partial improvement, the pH remains below 7.35, indicating ongoing mild acidosis. The bicarbonate level is still below normal, suggesting that buffering capacity is not yet fully restored. Additional treatment is required to completely normalize acid-base balance.
C. pH 7.38 and HCO₃⁻ 24 mEq/L. A pH of 7.38 falls within the normal range (7.35–7.45), indicating that acidosis has resolved. The bicarbonate level of 24 mEq/L is within normal limits, confirming that the body’s buffering system has been restored. These values suggest that ketoacidosis has resolved, and treatment has been effective.
D. pH 7.20 and HCO₃⁻ 15 mEq/L. A pH of 7.20 indicates severe metabolic acidosis, and a bicarbonate level of 15 mEq/L shows a significant loss of buffering capacity. These values suggest uncontrolled DKA or worsening acidosis, requiring urgent intervention with continued insulin therapy, fluid resuscitation, and electrolyte replacement.

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Correct Answer is D

Explanation

A. Creatine kinase-MB (CK-MB). CK-MB is a cardiac enzyme that rises 3-6 hours after myocardial injury and was previously used to diagnose myocardial infarction (MI). However, it is less specific than troponin and can be elevated in skeletal muscle damage, making troponin the preferred biomarker for cardiac injury.
B. Serum glutamic pyruvic transaminase (SGPT). SGPT (also known as alanine aminotransferase [ALT]) is a liver enzyme and is not a primary marker for cardiac injury. While cardiac arrest and hypoxia can lead to liver damage, monitoring cardiac-specific markers is the priority in this scenario.
C. Lactate dehydrogenase (LDH). LDH is a nonspecific marker of tissue damage that can be elevated in cardiac, hepatic, renal, or other organ injuries. It is not cardiac-specific and is no longer used as a primary diagnostic tool for MI.
D. Cardiac troponin. Troponin (T and I) is the most specific and sensitive biomarker for myocardial injury. The presence of ST elevation in multiple leads suggests acute myocardial infarction (MI) as the cause of cardiac arrest. Troponin levels begin to rise within 2-3 hours, peak at 12-24 hours, and remain elevated for 7-10 days, making them the most important laboratory value to monitor for ongoing cardiac damage.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D"}

Explanation

Compensated respiratory acidosis occurs when the lungs retain CO₂, causing acidosis, but the kidneys compensate by increasing bicarbonate (HCO₃⁻) levels. In this case, the pH is low, and the PaCO₂ is within normal limits, which does not indicate a respiratory issue or compensation. Compensation would require an elevated HCO₃⁻, which is not provided in the lab results.
Compensated metabolic acidosis would require a low pH with a decreased PaCO₂, as the respiratory system compensates by increasing ventilation (hyperventilation) to "blow off" CO₂. Since the PaCO₂ in this case is within normal limits, no significant respiratory compensation has occurred yet, making this uncompensated metabolic acidosis instead.
Uncompensated respiratory acidosis would present with a low pH and an elevated PaCO₂ (>45 mmHg) due to inadequate ventilation and CO₂ retention. Since the PaCO₂ here is 37 mmHg (within normal range), respiratory acidosis is unlikely. The metabolic component, rather than a respiratory problem, is driving the acidosis.
Uncompensated metabolic acidosis is characterized by a low pH (7.23) and a normal PaCO₂ (37 mmHg), indicating a primary metabolic problem without sufficient respiratory compensation. In diabetic ketoacidosis (DKA), the lack of insulin results in fat breakdown and ketone production, leading to a drop in pH and metabolic acidosis. This client likely has DKA due to their history of type 1 diabetes and the lack of insulin administration.
Kussmaul respirations are a compensatory response to metabolic acidosis, seen in conditions like DKA. However, they do not cause acidosis; instead, they are the body's attempt to correct it by exhaling CO₂. Since the ABG shows normal PaCO₂, there is no strong evidence of hyperventilation, suggesting compensation has not yet occurred.
Starvation can lead to ketoacidosis due to prolonged fasting and fat metabolism, producing ketones. However, in type 1 diabetes, the primary issue is no insulin production, not caloric deprivation. The severity of metabolic acidosis in this client is more likely due to insulin deficiency rather than starvation.
Tissue hypoxia leads to lactic acidosis, which results from anaerobic metabolism. This can be seen in conditions like sepsis or shock. However, in this case, the client has type 1 diabetes, and the more likely cause of acidosis is ketoacidosis due to insulin deficiency rather than hypoxia.
A lack of insulin in type 1 diabetes prevents glucose uptake, forcing the body to break down fat, leading to ketone formation and metabolic acidosis. This matches the clinical scenario of a patient with a history of type 1 diabetes, hyperglycemia >500 mg/dL, and metabolic acidosis.

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Exhibits Complete the following sentence by choosing from the lists of options. A pH level of ________ and bicarbonate (HCO3-) level of________indicate a resolution of ketoacidosis.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Exhibits Drag one condition and one client finding to complete the sentence(s). Based on the ABG values, the nurse knows that the client has dropdownrelated todropdown

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D"}

Explanation

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Exhibits

Complete the following sentence by choosing from the lists of options.

A pH level of and bicarbonate (HCO3-) level ofindicate a resolution of ketoacidosis.