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 D
Explanation
Choice A reason: This is incorrect because amino acids are electrolytes. Electrolytes are substances that dissociate into ions when dissolved in water and conduct electricity. Amino acids have both positive and negative charges and can form ions in solution.
Choice B reason: This is incorrect because magnesium is an electrolyte. Magnesium is a metal that forms positive ions (cations) when dissolved in water. Magnesium is important for muscle and nerve function, as well as bone health.
Choice C reason: This is incorrect because phosphates are electrolytes. Phosphates are compounds that contain the phosphate ion (PO4 3-), which is a negative ion (anion) in solution. Phosphates are involved in energy metabolism, acid-base balance, and bone formation.
Choice D reason: This is correct because glucose is a nonelectrolyte. Nonelectrolytes are substances that do not dissociate into ions when dissolved in water and do not conduct electricity. Glucose is a simple sugar that dissolves as a whole molecule in water. Glucose is the main source of energy for the body.
Correct Answer is D
Explanation
Choice A reason: 60 mL of urine in a 2-hour period is not very concerning for a nurse, as it is within the normal range of urine output. The average urine output for an adult is about 1 to 2 L per day, or 40 to 80 mL per hour¹.
Choice B reason: 720 mL of urine in a 24-hour period is slightly below the normal range, but not alarming. It may indicate mild dehydration or reduced fluid intake, but it is not a sign of fluid volume excess or kidney failure¹.
Choice C reason: 600 mL of urine in a 10-hour period is also within the normal range of urine output, and does not indicate any problem with fluid balance or renal function¹.
Choice D reason: 100 mL of urine in a 5-hour period is the most concerning for a nurse, as it indicates oliguria, or abnormally low urine output. Oliguria is defined as urine output less than 400 mL per day, or less than 20 mL per hour². It may be caused by acute or chronic kidney injury, urinary obstruction, shock, dehydration, or fluid volume excess². Oliguria can lead to fluid overload, electrolyte imbalance, acidosis, and uremia, and requires immediate medical attention².
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