Ms. Jackson has been suffering from 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 acid-base disorder is shown?
Metabolic Alkalosis. Partially Compensated
Respiratory Acidosis, Partially Compensated
Respiratory Alkalosis. Uncompensated
Metabolic Alkalosis. Uncompensated
The Correct Answer is D
A. Metabolic Alkalosis, Partially Compensated, is incorrect because there is no evidence of respiratory compensation (normal PaCO2).
B. Respiratory Acidosis, Partially Compensated, is incorrect because the pH is high, not low as would be expected in acidosis, and the PaCO2 is normal, not high.
C. Respiratory Alkalosis, Uncompensated, is incorrect because the primary problem is metabolic (high HCO3), not respiratory, and the PaCO2 is normal, not low as would be seen in respiratory alkalosis.
D. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. In this scenario, the pH is elevated (7.5) and the bicarbonate (HCO3) level is high (34 mmol/L), indicating alkalosis. Vomiting leads to loss of gastric acid (hydrochloric acid), causing metabolic alkalosis. The respiratory system has not yet compensated fully for the alkalosis, as indicated by the normal PaCO2 (40 mm Hg).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Metabolic Alkalosis, Partially Compensated, is incorrect because there is no evidence of respiratory compensation (normal PaCO2).
B. Respiratory Acidosis, Partially Compensated, is incorrect because the pH is high, not low as would be expected in acidosis, and the PaCO2 is normal, not high.
C. Respiratory Alkalosis, Uncompensated, is incorrect because the primary problem is metabolic (high HCO3), not respiratory, and the PaCO2 is normal, not low as would be seen in respiratory alkalosis.
D. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. In this scenario, the pH is elevated (7.5) and the bicarbonate (HCO3) level is high (34 mmol/L), indicating alkalosis. Vomiting leads to loss of gastric acid (hydrochloric acid), causing metabolic alkalosis. The respiratory system has not yet compensated fully for the alkalosis, as indicated by the normal PaCO2 (40 mm Hg).
Correct Answer is D
Explanation
A. Consuming excessive animal protein can increase the risk of kidney stones due to the metabolism of protein leading to increased excretion of calcium and oxalate.
B. Restricting calcium intake is not recommended for preventing calcium oxalate kidney stones. Adequate calcium intake from dietary sources can actually help prevent kidney stone formation by binding to oxalate in the intestines and reducing its absorption.
C. High doses of vitamin C can increase oxalate levels in the urine, which can contribute to the formation of calcium oxalate kidney stones.
D. Adequate fluid intake, typically recommended at least 3 liters (about 100 ounces) per day, helps dilute urine and reduce the concentration of stone-forming substances, thereby reducing the risk of kidney stone formation.
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