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 B
Explanation
A. The erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not used to assess the therapeutic effect of epoetin alfa.
B. The hematocrit (Hct) measures the proportion of red blood cells in the blood. Epoetin alfa stimulates the production of red blood cells, leading to an increase in hematocrit levels, indicating a therapeutic effect of the medication.
C. The leukocyte count measures the number of white blood cells in the blood and is not relevant for assessing the therapeutic effect of epoetin alfa.
D. The platelet count measures the number of platelets in the blood and is not relevant for assessing the therapeutic effect of epoetin alfa.
Correct Answer is C
Explanation
A. Ondansetron is an antiemetic commonly used to prevent nausea and vomiting, and it is not typically associated with nephrotoxicity.
B. Diphenhydramine is an antihistamine used for allergy symptoms and as a sleep aid. It is not known to cause nephrotoxicity.
C. Vancomycin is an antibiotic that can cause nephrotoxicity, especially when administered in high doses or in individuals with impaired renal function. Monitoring renal function is crucial when using vancomycin.
D. Omeprazole is a proton pump inhibitor used to reduce gastric acid secretion and treat conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers. It is not associated with nephrotoxicity.
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