Mrs. Kalen is a 70 year old female who has arrived into the ER due to persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What would you interpret the acid-base disorder to be?

Uncompensated Respiratory Acidosis

Fully Compensated Metabolic Acidosis

Uncompensated Metabolic Alkalosis

Partially Compensated Respiratory Alkalosis

Answer and Explanation

The Correct Answer is C

The pH value of 7.5 indicates alkalosis, as it is above the normal range of 7.35-7.45. The elevated bicarbonate (HCO3-) level of 34 mmol/L suggests metabolic alkalosis, as it is higher than the normal range of 22-28 mmol/L. The PaCO2 level of 40 mm Hg falls within the normal range of 35-45 mm Hg.

In this case, the primary disturbance is metabolic alkalosis, which is likely caused by vomiting leading to excessive loss of gastric acid (hydrogen ions) and chloride ions from the stomach. This loss of acid and chloride results in an imbalance of electrolytes and an increase in bicarbonate levels, leading to metabolic alkalosis.

The arterial blood gas results do not indicate any compensation. Compensation occurs when the body attempts to restore the pH balance by adjusting the respiratory or metabolic systems. In this case, there is no compensation observed because the PaCO2 level is within the normal range and not significantly altered.

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Correct Answer is C

Explanation

0.9% Sodium chloride is a balanced isotonic solution that closely resembles the electrolyte composition of the extracellular fluid. It is commonly used to treat dehydration because it helps restore fluid volume and electrolyte balance in the body.

5% dextrose in Lactated Ringers: This solution is typically used for fluid and electrolyte replacement in patients who have significant fluid losses or imbalances, but it may not be the best choice for dehydration alone.

0.45% sodium chloride: This solution, also known as half-normal saline, has a lower concentration of sodium chloride and is often used for patients who require hypotonic fluids. It may not provide enough electrolyte replacement for a dehydrated patient. 3% Normal Saline: This solution has a higher concentration of sodium chloride and is typically used for specific indications, such as severe hyponatremia or in critical care settings. It is not the first-line choice for treating dehydration.

A. Place the child in a quiet environment. B. Apply lotion to hands and feet. C. Encourage the parents to rest when possible. D. Make a list of foods that the child likes.

Correct Answer is A

Explanation

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Naxlex Comprehensive Predictor Exams

Based on the diagnosis of Dehydration, select which IV solution will be ordered to treat waiting this patient.

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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Select Dropdowns: Aminoglycosides work by binding to the dropdown which prevents dropdown

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