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  • August 13, 2024
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  • 2024/2025
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4335: Midterm, ABGs
1, 2, 3, 4

Excess Nasogastric suctioning may lead to metabolic alkalosis (lose acid from stomach) -
ANS-Metabolic Acidosis can occur due to (Excess carbonic acid or base bicarbonate deficit
caused by):
1. Ketoacidosis
2. Lactic acid accumulation (shock)
3. Severe diarrhea
4. Kidney disease
5. Nasogastric suctioning

1. 7.35-7.45
2. 35-45
3. 22-26 - ANS-ABG normal ranges for:
1. pH
2. PaCO2
3. HCO3

A - ANS-In metabolic alkalosis, the blood pH level:
A. Increases
B. Decreases
C. Stays the same

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

ABG interpretation: Normal - ANS-pH: 7.40; CO2: 40; HCO3: 25

ABG Interpretation: Partially compensated metabolic acidosis - ANS-pH: 7.15; CO2: 33; HCO3:
20

, ABG Interpretation: Partially Compensated respiratory alkalosis - ANS-Interpret the following
ABGs:
pH: 7.79; CO2: 24; HCO3: 21

ABG Interpretation: Uncompensated Metabolic Acidosis - ANS-ph: 7.17; CO2: 35; HCO3: 12

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

Answer: 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

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.

B


Diamox (Acetazolamide) is an inhibitor of carbonic anhydrase that stimulates the respiratory
centre by creating a mild metabolic acidosis.
You can figure out the answer to this Q by eliminating all other answers (A, C, D all cause
metabolic alkalosis) - ANS-What of the following is NOT a cause of metabolic alkalosis?
A. Hyperaldosteronism
B. Usage of Diamox
C. Nasogastric suctioning

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