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?
Metabolic alkalosis, uncompensated
Respiratory alkalosis, uncompensated
Respiratory acidosis, uncompensated
Metabolic acidosis, uncompensated
The Correct Answer is D
Choice A reason: This is incorrect because metabolic alkalosis is characterized by a high pH and a high HCO3-. The patient's pH and HCO3- are both low, indicating acidosis, not alkalosis.
Choice B reason: This is incorrect because respiratory alkalosis is characterized by a high pH and a low PaCO2. The patient's pH is low and PaCO2 is normal, indicating a metabolic problem, not a respiratory one.
Choice C reason: This is incorrect because respiratory acidosis is characterized by a low pH and a high PaCO2. The patient's pH is low, but PaCO2 is normal, indicating a metabolic problem, not a respiratory one.
Choice D reason: This is correct because metabolic acidosis is characterized by a low pH and a low HCO3-. The patient's pH and HCO3- are both low, indicating a metabolic disorder. The condition is uncompensated because the PaCO2 is normal, meaning the respiratory system is not compensating for the metabolic acidosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is D
Explanation
Choice A reason: Intracellular to the extracellular fluid shift is not the cause of low blood pressure in this case. This fluid shift occurs when the cells lose water due to osmosis, such as in dehydration or hypernatremia.
Choice B reason: Interstitial to intravascular fluid shift is not the cause of low blood pressure in this case. This fluid shift occurs when the fluid moves from the tissue spaces to the blood vessels, such as in hypovolemia or hypotonic fluid administration.
Choice C reason: Interstitial to the intracellular fluid shift is not the cause of low blood pressure in this case. This fluid shift occurs when the fluid moves from the tissue spaces to the cells, such as in overhydration or hyponatremia.
Choice D reason: Intravascular to the interstitial fluid shift is the cause of low blood pressure in this case. This fluid shift occurs when the fluid moves from the blood vessels to the tissue spaces, such as in edema, inflammation, or increased capillary permeability. This reduces the blood volume and lowers the blood pressure.
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