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

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: This is incorrect because normal saline is not indicated for this client. Normal saline is a isotonic solution that does not alter the acid-base balance. The client has respiratory alkalosis, which is caused by hyperventilation and results in a high pH and a low PaCO2.

Choice B reason: This is incorrect because Allen's test is not relevant for this client. Allen's test is a test to assess the patency of the radial and ulnar arteries before performing an arterial blood gas (ABG) sampling or cannulation. The client already has ABG results, so there is no need to perform Allen's test.

Choice C reason: This is incorrect because increasing breathing would worsen the client's condition. Increasing breathing would cause the client to exhale more carbon dioxide, which would lower the PaCO2 and raise the pH even more. This would increase the severity of respiratory alkalosis.

Choice D reason: This is correct because slowing down breathing would help the client to correct the respiratory alkalosis. Slowing down breathing would allow the client to retain more carbon dioxide, which would increase the PaCO2 and lower the pH. This would bring the acid-base balance closer to normal.

A. 2200 mL B. 3000 mL C. 3800 mL D. 2400 mL

Correct Answer is A

Explanation

Choice A reason: For an average adult, the total intake should be approximately equal to the total output every day¹². Therefore, if the patient's total output is 2200 mL, the total intake should also be around 2200 mL.

Choice B reason: 3000 mL is more than the recommended daily fluid intake for an average adult, which is about 2500 mL³. If the patient's intake is higher than their output, they may develop fluid overload or edema.

Choice C reason: 3800 mL is much more than the recommended daily fluid intake for an average adult, which is about 2500 mL³. If the patient's intake is higher than their output, they may develop fluid overload or edema.

Choice D reason: 2400 mL is slightly less than the recommended daily fluid intake for an average adult, which is about 2500 mL³. However, if the patient's intake is lower than their output, they may develop dehydration or electrolyte imbalance.

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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?

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Naxlex Comprehensive Predictor Exams

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Explanation

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