The nurse is caring for a patient with metabolic acidosis. Which laboratory findings will the nurse expect to support this diagnosis? (Select All That Apply)

pH less than 7.35

HCO3 less than 22 mEq/L

PaCO2 greater than 45 mmHg

PaO2 less than 80 mmHg

SpO2 greater than 95%

Answer and Explanation

Correct Answer : A,B,C

Choice A reason: A pH less than 7.35 indicates an acidic state, which is consistent with metabolic acidosis. The normal pH range is 7.35 to 7.45.

Choice B reason: HCO3 (bicarbonate) less than 22 mEq/L indicates a low level of bicarbonate, which is consistent with metabolic acidosis. Bicarbonate is a base, and lower levels indicate a loss of buffering capacity.

Choice C reason: PaCO2 greater than 45 mmHg is not a primary indicator of metabolic acidosis but can occur as a compensatory mechanism in response to respiratory acidosis. The primary indicators of metabolic acidosis are low pH and low bicarbonate.

Choice D reason: PaO2 less than 80 mmHg indicates hypoxemia but is not directly related to the diagnosis of metabolic acidosis. Hypoxemia can occur with various conditions, and while it may be present, it is not a defining characteristic of metabolic acidosis.

Choice E reason: SpO2 greater than 95% indicates normal oxygen saturation and is not relevant to the diagnosis of metabolic acidosis. Oxygen saturation primarily reflects respiratory function rather than acid-base balance.

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Correct Answer is B

Explanation

Choice A reason: Respiratory alkalosis with partial compensation is characterized by a high pH, low PaCO2, and a compensatory decrease in HCO3. In this case, the pH is high (alkaline), PaCO2 is high, and HCO3 is elevated, indicating that the primary disorder is metabolic alkalosis, not respiratory alkalosis.

Choice B reason: Metabolic alkalosis with partial compensation is indicated by a high pH (alkaline), high HCO3 (bicarbonate), and a high PaCO2 (carbon dioxide) as a compensatory mechanism by the respiratory system. In this case, the pH is 7.52 (alkaline), PaCO2 is 55 mmHg, and HCO3 is 30 mEq/L, which fits the profile of metabolic alkalosis with the respiratory system attempting to compensate by retaining CO2.

Choice C reason: Metabolic alkalosis with no compensation would present with a high pH and high HCO3, but normal PaCO2. In this case, the PaCO2 is elevated, indicating that there is some level of respiratory compensation occurring, which rules out the "no compensation" scenario.

Choice D reason: Metabolic acidosis with partial compensation would present with a low pH, low HCO3, and low PaCO2 as a compensatory mechanism. In this case, the pH is high (alkaline), not low, which is inconsistent with metabolic acidosis.

A. Apply a hypothermia blanket. B. Administer humidified oxygen. C. Administer aspirin 325 mg orally. D. Administer D5NS intravenous infusion. E. Administer propylthiouracil.

Correct Answer is ["A","B","D","E"]

Explanation

Choice A reason: Applying a hypothermia blanket is appropriate for managing hyperthermia in a patient with Graves' disease. Elevated temperatures (fever) are common in thyroid storm, a severe complication of Graves' disease. Using a hypothermia blanket helps reduce the body temperature and prevent further complications.

Choice B reason: Administering humidified oxygen is important for supporting respiratory function in a patient with increased respiratory rate and decreased level of consciousness. Humidified oxygen can help alleviate respiratory distress and improve oxygenation.

Choice C reason: Administering aspirin 325 mg orally is not recommended for patients with hyperthyroidism or thyroid storm. Aspirin can increase free thyroid hormone levels by displacing thyroid hormone from its binding proteins, potentially worsening the patient's condition. Acetaminophen is a safer alternative for managing fever in these patients.

Choice D reason: Administering D5NS intravenous infusion is appropriate for managing dehydration and electrolyte imbalances in a patient with thyroid storm. This intervention helps maintain fluid balance and provides dextrose for energy.

Choice E reason: Administering propylthiouracil is a key intervention for managing thyroid storm. Propylthiouracil inhibits thyroid hormone synthesis and peripheral conversion of T4 to T3, helping to reduce thyroid hormone levels and alleviate symptoms.

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The nurse is caring for a patient with metabolic acidosis. Which laboratory findings will the nurse expect to support this diagnosis? (Select All That Apply)

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