Examkin

Soru

Zorluk: KolayPhysiological Adaptation

A nurse is caring for a client who has been receiving continuous nasogastric (NG) tube suctioning for the past 48 hours. The nurse reviews the client's most recent arterial blood gas (ABG) results:

ParameterResult
pH7.54
PaCO240 mm Hg
HCO3-30 mEq/L

Based on these results, which acid-base imbalance is the client experiencing?

  1. Uncompensated metabolic alkalosisCevap
  2. B
    Uncompensated respiratory alkalosis
  3. C
    Uncompensated metabolic acidosis
  4. D
    Uncompensated respiratory acidosis

Cevap

Uncompensated metabolic alkalosis
The client is experiencing uncompensated metabolic alkalosis. The pH is elevated (greater than 7.45), indicating alkalosis. The bicarbonate (HCO3-) is also elevated (greater than 26 mEq/L), which matches the alkalotic pH and confirms a metabolic origin. The PaCO2 is within the normal range (35-45 mm Hg), meaning the respiratory system has not yet begun to compensate by retaining carbon dioxide. Furthermore, continuous nasogastric suctioning depletes gastric acid (hydrochloric acid), a common clinical cause of metabolic alkalosis.

Adım Adım Çözüm

1
Analyze the pH to determine if acidosis or alkalosis is present.
The pH is 7.54, which is greater than the normal range of 7.35 to 7.45. This indicates alkalosis.
Establishing the overall acid-base status is the first step in ABG interpretation.
2
Evaluate the PaCO2 and HCO3- to determine the primary cause of the alkalosis.
The HCO3- is 30 mEq/L (elevated above normal 22-26 mEq/L), which aligns with the alkalotic pH. The PaCO2 is 40 mm Hg, which is within the normal range (35-45 mm Hg).
Matching the abnormal value to the pH determines whether the imbalance is respiratory or metabolic in origin.
3
Determine the level of compensation.
Because the PaCO2 is normal, the respiratory system has not yet initiated a compensatory response to retain CO2.
A normal opposing value in the presence of an abnormal primary value indicates an uncompensated state.

Anahtar Kavram

Arterial Blood Gas (ABG) Interpretation
Bu soruyu puanla

Konular

Physiological Adaptation

Bu konudan daha fazla soru