The nurse reviews the arterial blood gas results of a client and notes the following:
pH 7.45, [normal range: 7.35-7.45]
Paco2 of 30 mm Hg (30 mmol/L), [normal range: 35-45]
HCO3- of 20 mEq/L (20 mmol/L), [normal range: 22-26]
Which condition would the nurse analyze these results to indicate?
Metabolic alkalosis
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis
The Correct Answer is C
A. Metabolic alkalosis is characterized by a high pH and a high HCO3- level; this does not match the provided values.
B. Metabolic acidosis would show a low pH and a low HCO3-, which does not match the findings.
C. The pH is high (7.45) while the Paco2 is low (30 mm Hg), indicating respiratory alkalosis. The low HCO3- could be a compensatory mechanism but does not change the primary interpretation of respiratory alkalosis.
D. Respiratory acidosis would be indicated by a low pH and a high Paco2, which is not the case here.
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Correct Answer is C
Explanation
A. Metabolic alkalosis is characterized by a high pH and elevated bicarbonate levels, which is not present in these results.
B. Respiratory alkalosis would present with an increased pH and decreased PaCO2, which does not apply here.
C. The low pH (7.12) indicates acidemia, and the elevated PaCO2 (90 mm Hg) suggests hypoventilation and respiratory acidosis due to CO2 retention. The bicarbonate level is within normal limits, further supporting respiratory acidosis.
D. Metabolic acidosis would be indicated by a low pH and low bicarbonate levels; however, the bicarbonate is normal in this case, ruling out metabolic acidosis.
Correct Answer is B
Explanation
A. Asystole: Asystole would show a flat line with no electrical activity, which is not seen here.
B. Ventricular fibrillation: Ventricular fibrillation is characterized by chaotic, irregular waveforms without distinct P waves, QRS complexes, or T waves. The ECG strip shows this disorganized, erratic electrical activity consistent with ventricular fibrillation.
C. Sinus tachycardia: Sinus tachycardia would display a regular rhythm with identifiable P waves, QRS complexes, and T waves at a faster rate. This is not present in the ECG strip.
D. Sinus bradycardia: Sinus bradycardia would show a slower rate but with an organized rhythm and distinct P, QRS, and T waves. This is not indicated in the strip.