George Torres is admitted with a head injury. He is comatose and is breathing rapidly. His blood gases show a pH of 7.47, PaCO2 of 32 mm Hg, and HCO3- of 26 mEq/L. Compare these gases to normal values. What type of imbalance does this patient have, and is it being compensated or uncompensated?
Metabolic alkalosis, uncompensated
Respiratory acidosis, uncompensated
Respiratory alkalosis, uncompensated
Metabolic acidosis, uncompensated
The Correct Answer is C
Choice A reason: Metabolic alkalosis is a condition where the pH and the HCO3- are both elevated, indicating a loss of acids or a gain of bases in the body. This is not the case for this patient, as his HCO3- is within the normal range of 22 to 26 mEq/L.
Choice B reason: Respiratory acidosis is a condition where the pH and the PaCO2 are both low, indicating a retention of carbon dioxide in the lungs due to hypoventilation. This is not the case for this patient, as his pH is high and his PaCO2 is low.
Choice C reason: Respiratory alkalosis is a condition where the pH and the PaCO2 are both high, indicating a loss of carbon dioxide in the lungs due to hyperventilation. This is the case for this patient, as his pH is above the normal range of 7.35 to 7.45 and his PaCO2 is below the normal range of 35 to 45 mm Hg. This condition is uncompensated, as his HCO3- is within the normal range and has not changed to counteract the pH imbalance.
Choice D reason: Metabolic acidosis is a condition where the pH and the HCO3- are both low, indicating a gain of acids or a loss of bases in the body. This is not the case for this patient, as his pH is high and his HCO3- is within the normal range.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This is incorrect because bradypnea is a term for slow breathing, usually less than 12 breaths per minute. The client is breathing rapidly, not slowly.
Choice B reason: This is correct because Kussmaul's respirations are a type of breathing pattern that is deep, regular, and rapid, usually more than 20 breaths per minute. Kussmaul's respirations are a sign of metabolic acidosis, which occurs in diabetic ketoacidosis due to the accumulation of ketones in the blood. The client is trying to exhale the excess carbon dioxide and lower the acidity of the blood.
Choice C reason: This is incorrect because Cheyne-Stokes respirations are a type of breathing pattern that is irregular, with periods of apnea (no breathing) alternating with periods of rapid breathing. Cheyne-Stokes respirations are a sign of cerebral dysfunction, such as stroke, brain injury, or coma.
Choice D reason: This is incorrect because Biot's respirations are a type of breathing pattern that is irregular, with periods of apnea (no breathing) interspersed with periods of normal breathing. Biot's respirations are a sign of brainstem damage, such as meningitis, encephalitis, or head trauma.
Correct Answer is A
Explanation
Choice A: Elderly patients are at a higher risk for dehydration due to physiological changes that come with aging, such as decreased kidney function and physical changes to the body's water balance systems. Additionally, fever increases metabolic rate and fluid loss, and nausea and vomiting prevent adequate fluid intake, further increasing the risk of dehydration.
Choice B: While intentionally limiting fluid intake can lead to dehydration, the body's thirst mechanism in a healthy teenager is typically strong enough to prevent severe dehydration.
Choice C: Diarrhea can certainly lead to dehydration, but a young, otherwise healthy patient typically has a stronger ability to recover from fluid loss than an elderly patient.
Choice D: Infants are at a higher risk for dehydration than older children and adults due to their smaller body weight and higher turnover of water and electrolytes, but in this case, the elderly patient's multiple risk factors put them at a higher risk overall.
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