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4335_ Midterm, ABGs (1).
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4335_ Midterm, ABGs (1).
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4335: Midterm, ABGsAnswer: A
Rationale: The lungs excrete carbonic acid. The kidneys excrete metabolic acids. - ANS-Which
two organs are responsible for acid excretion, which helps maintain acid-base balance?
A. Lungs and kidneys
B. Kidneys and liver
C. Bladder and bowel
D. Lungs and bladder
A. When the patient has metabolic acidosis, the kidneys are not combining H+ with ammonia to
form ammonium or eliminating acid with secretion of free hydrogen into the renal tubule. The
buffer system neutralizes HCl acid by forming a weak acid. The hormone system is not directly
related to acid-base balance. The respiratory system releases CO2 that combines with water to
form hydrogen ions and bicarbonate. The hydrogen is then buffered by the hemoglobin. - ANS-A
patient is admitted with metabolic acidosis. Which system is not functioning normally?
A. Renal system
B. Buffer system
C. Endocrine system
D. Respiratory system
1. 7.35-7.45
2. 35-45
3. 22-26 - ANS-ABG normal ranges for:
1. pH
2. PaCO2
3. HCO3
Answer: Metabolic alkalosis
Rationale: Metabolic alkalosis occurs from a direct increase of base HCO-3 or a decrease of
metabolic acid, which increases blood HCO-3 by releasing it from its buffering function. - ANS-A
student studies the difference between metabolic acidosis and alkalosis. They know that what
state increases blood HCO-3.
Answer: 3.
The pH is abnormally low, which indicates acidosis. The PaCO2 is high, which indicates
respiratory acidosis. The HCO3 - is in the normal range, which indicates an acute respiratory
acidosis that has not had time for renal compensation (Uncompensated). The low PaO2 and the
severe dyspnea and wheezing are consistent with this interpretation. - ANS-A patient is
admitted to the hospital with severe dyspnea and wheezing. Arterial blood gas levels on
, admission are pH 7.26; PaCO2, 55 mm Hg; PaO2, 68 mm Hg; and HCO3 - , 24. How does the
nurse interpret these laboratory values?
1. Metabolic acidosis
2. Metabolic alkalosis
3. Respiratory acidosis
4. Respiratory alkalosis
B.
A low pH (normal, 7.35 to 7.45) indicates acidosis. In a patient with respiratory disease such as
COPD, the patient retains carbon dioxide (normal, 35 to 45 mm Hg), which acts as an acid in
the body. For this reason, the patient has respiratory acidosis. The elevated HCO3 indicates a
partial compensation for the elevated CO2. - ANS-You are caring for a patient admitted with a
diagnosis of chronic obstructive pulmonary disease (COPD) who has the following arterial blood
gas results: pH 7.33, PaO2 47 mm Hg, PaCO2 60 mm Hg, HCO3 32 mEq/L, and O2 saturation
of 92%. What is the correct interpretation of these results?
A. Fully compensated respiratory alkalosis
B. Partially compensated respiratory acidosis
C. Normal acid-base balance with hypoxemia
D. Normal acid-base balance with hypercapnia
True.
In the case of metabolic acidosis, which is an elevated bicarbonate state, hyperventilation will
'blow off' carbon dioxide, and thus acts as a buffer to partially or totally compensate for this
acidotic state. - ANS-T/F: Hyperventilation is a compensatory mechanism for metabolic acidosis.
D. Excessive nasogastric suctioning may cause metabolic alkalosis. Brain injury may cause
hyperventilation and respiratory alkalosis. Type 1 diabetes mellitus (diabetic ketoacidosis) is
associated with metabolic acidosis. Acute respiratory failure may lead to respiratory acidosis. -
ANS-The nurse on a medical-surgical unit identifies which patient as having the highest risk for
metabolic alkalosis?
A. A patient with a traumatic brain injury
B. A patient with type 1 diabetes mellitus
C. A patient with acute respiratory failure
D. A patient with nasogastric tube suction
B. Because gastric secretions are rich in HCl acid, the patient who is vomiting will lose a
significant amount of gastric acid and be at an increased risk for metabolic alkalosis. - ANS-You
are admitting a patient who reports abdominal pain, nausea, and vomiting. A proximal bowel
obstruction is suspected. Which acid-base imbalance do you anticipate in this patient?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
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