George Kent is a 54-year-old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L and Pa02 60 mm Hg.
How would you interpret this?
Metabolic Acidosis. Partially Compensated
Respiratory Acidosis, Uncompensated
Respiratory Acidosis, Partially Compensated
Metabolic Alkalosis Uncompensated
The Correct Answer is C
A. Metabolic acidosis would involve a low pH and low bicarbonate level, which is not evident in the given arterial blood gas results.
B. The low pH (acidosis) and high PaCO2 (respiratory component) indicate respiratory acidosis. The increased HCO3 (normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
C. George Kent's arterial blood gas values indicate a lower pH and an elevated PaCO2, which are consistent with respiratory acidosis. The increased HCO3 ((normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
D. Metabolic alkalosis is not supported by the given arterial blood gas results.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Metabolic Alkalosis, Partially Compensated, is incorrect because there is no evidence of respiratory compensation (normal PaCO2).
B. Respiratory Acidosis, Partially Compensated, is incorrect because the pH is high, not low as would be expected in acidosis, and the PaCO2 is normal, not high.
C. Respiratory Alkalosis, Uncompensated, is incorrect because the primary problem is metabolic (high HCO3), not respiratory, and the PaCO2 is normal, not low as would be seen in respiratory alkalosis.
D. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. In this scenario, the pH is elevated (7.5) and the bicarbonate (HCO3) level is high (34 mmol/L), indicating alkalosis. Vomiting leads to loss of gastric acid (hydrochloric acid), causing metabolic alkalosis. The respiratory system has not yet compensated fully for the alkalosis, as indicated by the normal PaCO2 (40 mm Hg).
Correct Answer is A
Explanation
A. Lethargy is a common symptom of hypothyroidism due to decreased metabolic rate and energy levels.
B. Photophobia is not typically associated with hypothyroidism.
C. Weight gain is more common in hypothyroidism due to slowed metabolism, rather than weight loss.
D. Exophthalmos is a characteristic feature of hyperthyroidism, not hypothyroidism.
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