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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?

A.

Metabolic Alkalosis. Partially Compensated

B.

Respiratory Acidosis, Partially Compensated

C.

Respiratory Alkalosis. Uncompensated

D.

Metabolic Alkalosis. Uncompensated

Answer and Explanation

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).
 


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Related Questions

Correct Answer is D

Explanation

A. Weight loss is not typically a manifestation of organ rejection post kidney transplant.

B. Insomnia is not typically associated with organ rejection post kidney transplant.

C. Normal body temperature does not indicate organ rejection post kidney transplant.

D. Oliguria or decreased urine output can be a sign of organ rejection post kidney transplant due to decreased renal perfusion.

Correct Answer is B

Explanation

A. While electrolyte imbalances can occur in nephrotic syndrome, hypomagnesemia is not typically associated with corticosteroid therapy.
B. Corticosteroid therapy can lead to increased urinary potassium loss and subsequent hypokalemia.
C. Corticosteroid therapy is not typically associated with hyperkalemia.
D. Hypermagnesemia is not typically associated with nephrotic syndrome or corticosteroid therapy.

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