MEDICINEnotes
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Baby Angela was rushed to the Emergency Room following her mother’s complaint that the infant has been irritable, difficult to breastfeed, and has had diarrhea for the past 3 days. The infant’s respiratory rate is elevated and the fontanels are sunken. The Emergency Room physician orders ABGs after assessing the ABCs. The results from the ABG results show pH 7.39, PaCO2 27 mmHg, and HCO3 19 mEq/L.
Mr. Wales, who underwent post-abdominal surgery, has a nasogastric tube. The nurse on duty notes that the nasogastric tube (NGT) is draining a large amount (900 cc in 2 hours) of coffee ground secretions. The client is not oriented to person, place, or time. The nurse contacts the attending physician and STAT ABGs are ordered. The results from the ABGs show pH 7.57, PaCO2 37 mmHg and HCO3 30 mEq/L.
Client Z is admitted to the hospital and is to undergo brain surgery. The client is very anxious and scared of the upcoming surgery. He begins to hyperventilate and becomes very dizzy. The client loses consciousness and the STAT ABGs reveal pH 7.61, PaCO2 22 mmHg, and HCO3 25 mEq/L.
Three-year-old Adrian is admitted to the hospital with a diagnosis of asthma and respiratory distress syndrome. The mother of the child reports to the nurse on duty that she has witnessed slight tremors and behavioral changes in her child over the past four days. The attending physician orders routine ABGs following an assessment of the ABCs. The ABG results are pH 7.35, PaCO2 72 mmHg, and HCO3 38 mEq/L.
Anne, who is drinking beer at a party, falls and hits her head on the ground. Her friend Liza dials “911” because Anne is unconscious, depressed ventilation (shallow and slow respirations), rapid heart rate, and is profusely bleeding from both ears.
Which primary acid-base imbalance is Anne at risk for if medical attention is not provided?
 
Anonymous Quiz
0%
A. Metabolic Acidosis  
20%
B. Metabolic Alkalosis  
40%
 C. Respiratory Acidosis
30%
 D. Respiratory Alkalosis
10%
E. Mixed acidosis alkalosis
Dave, a 6-year-old boy, was rushed to the hospital following her mother’s complaint that her son has been vomiting, nauseated and has overall weakness. After a series of tests, the nurse notes the laboratory results: potassium: 2.9 mEq.
Which primary acid-base imbalance is this boy at risk for if medical intervention is not carried out?
Anonymous Quiz
0%
A. Respiratory Acidosis
0%
B. Respiratory Alkalosis
13%
C. Metabolic Acidosis
88%
D. Metabolic Alkalosis
0%
E. None of the above
An older person experiencing homelessness was admitted to the emergency department due to shortness of breath, fever, and a productive cough. Upon examination, crackles and wheezes are noted in the lower lobes; he appears to be tachycardic and has a bounding pulse. Measurement of arterial blood gas shows pH 7.2, PaCO2 66 mm Hg, HCO3 27 mmol/L, and PaO2 65 mm Hg.
As a knowledgeable nurse, you know that the normal value for pH is:
Anonymous Quiz
8%
A. 7.20
31%
B. 7.30
62%
C. 7.40
0%
D. 7.50
0%
D. 8.00
Liza’s mother is seen in the emergency department at a community hospital. She admits that her mother is taking many tablets of aspirin (salicylates) over the last 24-hour period because of a severe headache. Also, the mother complains of an inability to urinate. The nurse on duty took her vital signs and noted the following: Temp = 97.8 °F; apical pulse = 95; respiration = 32 and deep.
Which primary acid-base imbalance is the client at risk for if medical attention is not provided?
Anonymous Quiz
27%
A. Respiratory Acidosis
9%
B. Respiratory Alkalosis
36%
C. Metabolic Acidosis
9%
D. Metabolic Alkalosis
18%
E. Mixed acidosis alkalosis
A patient who is hospitalized due to vomiting and a decreased level of consciousness displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. The doctor diagnosed him of having dehydration. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 22 mm Hg, and HCO3 14 mmol/L; other results are Na+ 120 mmol/L, K+ 2.5 mmol/L, and Cl- 95 mmol/L.
As a knowledgeable nurse, you know that the normal value for PaCO2 is:
Anonymous Quiz
29%
A. 22 mm Hg
53%
B. 36 mm Hg
12%
C. 48 mm Hg
6%
D. 50 mm Hg
0%
E. 52mm Hg
A company driver is found at the scene of an automobile accident in a state of emotional distress. He tells the paramedics that he feels dizzy, tingling in his fingertips, and does not remember what happened to his car. Respiratory rate is rapid at 34/minute.
Which primary acid-base disturbance is the young man at risk for if medical attention is not provided?
Anonymous Quiz
29%
A. Respiratory Acidosis
43%
B. Respiratory Alkalosis
14%
C. Metabolic Acidosis
0%
D. Metabolic Alkalosis
14%
E. I don't know