The nurse is reviewing the client's following arterial blood gases: pH 7.33, PaCo2 47, HCO3 24. Which manifestation would the nurse expect the client to be experiencing with this imbalance?

Confusion

Kussmaul's Respirations

Seizures

Paresthesia in the extremities

Answer and Explanation

The Correct Answer is A

A. Confusion: Respiratory acidosis (low pH + high PaCO2) leads to decreased oxygenation of brain tissues, causing confusion, drowsiness, and lethargy.

B. Kussmaul's Respirations: Seen in metabolic acidosis, not respiratory acidosis.

C. Seizures: Seizures are more common with alkalosis (high pH) due to neuronal excitability.

D. Paresthesia in the Extremities: More common in respiratory alkalosis due to calcium shifts.

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Correct Answer is B

Explanation

A. Respiratory Alkalosis: Would have low PaCO2 (<35 mmHg), not high.

B. Partially Compensated Metabolic Alkalosis: The pH is high (alkalosis), and the HCO3 is elevated, which indicates metabolic alkalosis. The PaCO2 is high, meaning the lungs are attempting to compensate by retaining CO₂ to lower the pH. Because the pH is still abnormal, this is partial compensation.

C. Metabolic Acidosis: Would have low pH and low HCO3 (<22 mEq/L).

D. Fully Compensated Respiratory Acidosis: The primary problem is metabolic, not respiratory.

A. Obtain vital signs B. Bolus the client with 1000 m of normal saline C. Turn off the dialysis machine immediately D. Notify the health care provider as soon as possible

Correct Answer is A

Explanation

A. Obtain vital signs: Dizziness and lightheadedness during dialysis suggest hypotension, a common complication. The nurse should first assess vital signs to determine the severity before taking further action.

B. Bolus the client with 1000 mL of normal saline: If the client is hypotensive, a smaller fluid bolus (e.g., 250–500 mL) would be more appropriate.

C. Turn off the dialysis machine immediately: Stopping dialysis abruptly may cause fluid overload and other complications. The rate may need adjustment but not immediate cessation.

D. Notify the health care provider as soon as possible: While important, assessing the client’s current status is the priority before contacting the provider.

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The nurse is reviewing the client's following arterial blood gases: pH 7.33, PaCo2 47, HCO3 24. Which manifestation would the nurse expect the client to be experiencing with this imbalance?

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