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: 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.

Choice A reason: This is incorrect because low HCO3- and high PaCO2 are signs of metabolic acidosis, not alkalosis. Metabolic acidosis is a condition where the blood pH is lower than the normal range of 7.35 to 7.45, due to an excess of acids or a loss of bases in the body.

Choice B reason: This is incorrect because low PaCO2 and low HCO3- are signs of respiratory acidosis, not alkalosis. Respiratory acidosis is a condition where the blood pH is lower than the normal range of 7.35 to 7.45, due to impaired gas exchange or hypoventilation, which causes carbon dioxide to accumulate in the blood.

Choice C reason: This is correct because low PaCO2 and high HCO3- are signs of alkalosis. Alkalosis is a condition where the blood pH is higher than the normal range of 7.35 to 7.45, due to a loss of acids or an excess of bases in the body. There are two types of alkalosis: respiratory and metabolic. Respiratory alkalosis is caused by hyperventilation, which lowers the PaCO2 in the blood. Metabolic alkalosis is caused by vomiting, diuretics, or excessive intake of antacids, which raises the HCO3- in the blood.

Choice D reason: This is incorrect because high PaCO2 and high HCO3- are signs of compensation, not alkalosis. Compensation is a process where the body tries to restore the normal pH by adjusting the levels of PaCO2 and HCO3- in the opposite direction of the primary disorder. For example, if the patient has metabolic alkalosis, the respiratory system will try to compensate by retaining carbon dioxide and lowering the PaCO2. If the patient has respiratory alkalosis, the renal system will try to compensate by excreting bicarbonate and lowering the HCO3-.