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Difficulty: EasyPhysiological Adaptation

A nurse is evaluating the arterial blood gas (ABG) results of a client who has severely depressed respirations following a suspected opioid overdose. The nurse determines the client is experiencing uncompensated respiratory acidosis. Which of the following ABG values would confirm this specific finding? Select all that apply.

  1. pH 7.31Answer
  2. PaCO2 58 mm HgAnswer
  3. HCO3- 23 mEq/LAnswer
  4. D
    pH 7.48
  5. E
    PaCO2 30 mm Hg

Answer

The values that confirm uncompensated respiratory acidosis are a pH of 7.31, PaCO2 of 58 mm Hg, and HCO3- of 23 mEq/L.
Uncompensated respiratory acidosis is characterized by a low pH (less than 7.35) and an elevated PaCO2 (greater than 45 mm Hg) due to inadequate ventilation. The bicarbonate (HCO3-) remains within the normal range (22 to 26 mEq/L) because the kidneys have not yet initiated a compensatory response.

Step-by-Step Solution

1
Analyze the pH to determine if the client is acidotic or alkalotic.
A pH less than 7.35 indicates acidosis. The value of 7.31 confirms acidemia.
Identifying the primary acid-base imbalance is the first step in ABG interpretation.
2
Evaluate the PaCO2 to determine if the cause is respiratory.
A PaCO2 greater than 45 mm Hg indicates a respiratory cause for the acidosis. The value of 58 mm Hg confirms hypercapnia.
Elevated carbon dioxide levels indicate hypoventilation, which drives respiratory acidosis.
3
Assess the HCO3- to determine the level of compensation.
An HCO3- within the normal range of 22 to 26 mEq/L indicates that no metabolic compensation has occurred yet. The value of 23 mEq/L confirms an uncompensated state.
In acute respiratory acidosis, it takes days for the kidneys to retain enough bicarbonate to compensate for the elevated CO2.

Key Concept

Uncompensated Respiratory Acidosis
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Topics

Physiological Adaptation

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