Lena Mason, who has diabetes, is admitted in a stuporous condition. Her blood gases show a pH of 7.33, PaCO2 of 40 mm Hg, and HCO3- of 20 mEq/L. What type of acid-base imbalance does this patient have?

Choice A reason: Panting with mouth open is not an appropriate intervention for an anxious patient with a high respiratory rate. This could increase the risk of hyperventilation and respiratory alkalosis, which could worsen the anxiety and cause symptoms such as dizziness, tingling, and muscle spasms.

Choice B reason: Sitting up is an appropriate intervention for an anxious patient with a high respiratory rate. This could help the patient relax and breathe more deeply and slowly, which could reduce the anxiety and normalize the blood gas levels.

Choice C reason: Lying down is not an appropriate intervention for an anxious patient with a high respiratory rate. This could make the patient feel more claustrophobic and increase the anxiety and the respiratory rate.

Choice D reason: Breathing through a re-breather mask is not an appropriate intervention for an anxious patient with a high respiratory rate. This could increase the oxygen concentration in the blood, which could reduce the stimulus for breathing and cause respiratory depression.

Choice A reason: This is incorrect because intracellular fluid is greater than extracellular fluid in a hypertonic state, not an isotonic state. A hypertonic state is when the solute concentration of the extracellular fluid is higher than the intracellular fluid, which causes water to move out of the cells and shrink them.

Choice B reason: This is incorrect because extracellular fluid is less than intracellular fluid in a hypotonic state, not an isotonic state. A hypotonic state is when the solute concentration of the extracellular fluid is lower than the intracellular fluid, which causes water to move into the cells and swell them.

Choice C reason: This is correct because intracellular and extracellular fluid is equal in an isotonic state. An isotonic state is when the solute concentration of the extracellular fluid is the same as the intracellular fluid, which causes no net movement of water across the cell membrane.

Choice D reason: This is incorrect because interstitial fluid is less than the transcellular fluid in a situation of fluid imbalance, not an isotonic state. Interstitial fluid is the fluid that surrounds the cells, while transcellular fluid is the fluid that is contained in specialized cavities, such as cerebrospinal fluid, synovial fluid, or pleural fluid. The amount of transcellular fluid is normally very small compared to the interstitial fluid, but it can increase in certain conditions, such as edema, ascites, or hydrocephalus.