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Difficulty: EasyPhysiological Adaptation

A client is being monitored on the medical-surgical unit for severe bilateral pneumonia. The most recent arterial blood gas (ABG) results show a pH of 7.31, PaCO2 of 56 mm Hg, and HCO3- of 24 mEq/L. Which of the following assessment findings correlate with this acid-base imbalance? Select all that apply.

  1. LethargyAnswer
  2. B
    Numbness and tingling of the extremities
  3. HeadacheAnswer
  4. D
    Positive Chvostek's sign
  5. RestlessnessAnswer

Answer

The correct findings associated with uncompensated respiratory acidosis include lethargy, headache, and restlessness.
The arterial blood gas results demonstrate uncompensated respiratory acidosis. Elevated PaCO2 levels cause cerebral vasodilation and central nervous system depression. This physiological adaptation directly leads to clinical findings such as headache, lethargy, and restlessness.

Step-by-Step Solution

1
Analyze the arterial blood gas (ABG) results.
The pH is 7.31 (acidosis), PaCO2 is 56 mm Hg (elevated, indicating a respiratory cause), and HCO3- is 24 mEq/L (normal, indicating lack of metabolic compensation).
Correctly identifying the acid-base imbalance is necessary to determine the expected physiological manifestations.
2
Identify the primary acid-base disorder.
The client has uncompensated respiratory acidosis.
The low pH combined with a high PaCO2 confirms a respiratory origin for the acidosis.
3
Correlate the acid-base disorder with clinical manifestations.
Respiratory acidosis is characterized by neurological depression, cerebral vasodilation (headache), and signs of hypoxia (restlessness, lethargy).
Elevated carbon dioxide levels directly affect the central nervous system and cerebral blood flow.

Key Concept

Respiratory Acidosis Clinical Manifestations
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Topics

Physiological Adaptation

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