Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?

pH = 7.46, PaCO2 = 44 mm Hg, PaO2 = 95 mm Hg, and HCO3 = 36 mEq/L.

pH = 7.27, PaCO2 = 70 mm Hg, PaO2 = 80 mm Hg, and HCO3 = 26 mEq/L.

pH = 7.30, PaCO2 = 35 mm Hg, PaO2 = 70 mm Hg, and HCO3 = 20 mEq/L.

pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.

Answer and Explanation

The Correct Answer is D

The correct answer is Choice D. Then start with Choice A rationale:

Choice A is incorrect because it represents metabolic alkalosis, not respiratory alkalosis. Metabolic alkalosis occurs when there is a primary increase in the bicarbonate (HCO3) level, which causes the pH to rise above the normal range (7.35-7.45). The PaCO2 is normal in this case, indicating that the respiratory system is not involved in the acid-base imbalance. Some causes of metabolic alkalosis include vomiting, diuretic use, excessive antacid intake, and mineralocorticoid excess 1.

Choice B is incorrect because it represents respiratory acidosis, not respiratory alkalosis. Respiratory acidosis occurs when there is a primary decrease in the PaCO2 level, which causes the pH to fall below the normal range. The HCO3 is normal in this case, indicating that the metabolic system is not involved in the acid-base imbalance. Some causes of respiratory acidosis include hypoventilation, airway obstruction, chest trauma, neuromuscular disorders, and chronic lung diseases 2.

Choice C is incorrect because it represents metabolic acidosis, not respiratory alkalosis. Metabolic acidosis occurs when there is a primary decrease in the HCO3 level, which causes the pH to fall below the normal range. The PaCO2 is normal in this case, indicating that the respiratory system is not involved in the acid-base imbalance. Some causes of metabolic acidosis include diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea, and poisoning 3.

Choice D is correct because it represents respiratory alkalosis. Respiratory alkalosis occurs when there is a primary decrease in the PaCO2 level, which causes the pH to rise above the normal range. The HCO3 is normal in this case, indicating that the metabolic system is not involved in the acid-base imbalance. Some causes of respiratory alkalosis include hyperventilation, anxiety, panic, fever, pain, tumor, trauma, severe anemia, liver disease, overdose of certain medicines, pulmonary embolism, pregnancy, and any lung disease that leads to shortness of breath . Respiratory alkalosis is characterized by symptoms such as breathlessness, dizziness, numbness, tingling, muscle spasms, chest discomfort, confusion, and fainting.

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Correct Answer is D

Explanation

Choice A rationale:

Stenosis of the heart valves typically leads to murmurs and changes in heart sounds but does not directly impact blood pressure regulation.

Choice B rationale:

Decreased adrenergic sensitivity might lead to lower heart rate and blood pressure, not an increase in systolic blood pressure as seen in this case.

Choice C rationale:

Increased parasympathetic activity would lead to decreased heart rate, not an increase in systolic blood pressure as observed in the patient.

Choice D rationale:

Loss of elasticity in arterial vessels is the correct answer. With aging, arterial walls become less flexible and more rigid due to the accumulation of calcium and collagen. This loss of elasticity results in increased systolic blood pressure, which is the top number in a blood pressure reading. The diastolic pressure, represented by the bottom number, does not usually increase significantly with age. This change is a result of arteriosclerosis, which commonly occurs in elderly individuals.

A. Peripheral arterial disease. B. Lymphatic obstruction. C. Chronic venous insufficiency. D. Musculoskeletal abnormalities.

Correct Answer is A

Explanation

Choice A rationale:

The patient's symptoms of leg pain that worsens at night and occurs when the legs are elevated but improves when they are dangled are indicative of peripheral arterial disease (PAD) PAD is a condition caused by the narrowing of arteries in the legs due to atherosclerosis. This narrowing restricts blood flow to the muscles, causing pain, especially during activities or positions that demand increased blood flow like walking or elevating the legs.

Choice B rationale:

Lymphatic obstruction typically does not cause pain in the same manner described by the patient. Lymphatic obstruction may cause swelling and discomfort, but it usually does not lead to pain that worsens with elevation and improves with dangling.

Choice C rationale:

Chronic venous insufficiency can cause leg pain and swelling, especially when standing for extended periods. However, the characteristic of pain worsening at night and with leg elevation points more towards arterial issues like PAD rather than venous insufficiency.

Choice D rationale:

Musculoskeletal abnormalities could cause localized pain, but the pattern described by the patient (worsening at night, relief with dangling) is not typical of musculoskeletal issues. PAD, on the other hand, often presents with these specific symptoms due to compromised blood flow to the muscles in the legs.

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Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?

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