Quiz 12: Assessment and Care of Patients With Acid-Base Imbalances

Nursing

A patient is brought unconscious to the emergency ward. He had been drinking heavily at the party but had not eaten for the past 2 days. His vital signs are: • Temperature - 97.8 o F • P - 48 • R - 28 • BP - 88/50 ABG results are: • pH - 7.31 • HCO 3 - - 25 mEq/l • PaCO 2 - 28 mm Hg • PaO 2 - 99 mm Hg The diagnosis is metabolic acidosis. The decrease in PaCO 2 and the low pH is indicative of metabolic acidosis.

For a patient who is insufficiently mechanically ventilated, with the pH of 7.29, the acid base problem the nurse diagnosis is discussed below. Option A is not correct since it is not metabolic acidosis. The symptoms clearly show mechanical ventilation which indicates that it is respiratory acidosis. Option B is not correct since it is not metabolic acidosis. The symptoms clearly show mechanical ventilation which indicates that it is respiratory acidosis. Option C is also not correct since an acid excess leads the low pH indicates underproduction of bicarbonate ions. Option D is the correct option since the mechanical ventilation indicates respiratory acidosis. Respiratory acidosis with base deficit is seen since the bicarbonate ions are over eliminated. Hence, the correct option is D. Respiratory acidosis with base deficit.

A patient is brought unconscious to the emergency ward. He had been drinking heavily at the party but had not eaten for the past 2 days. His vital signs are: • Temperature - 97.8 o F • P - 48 • R - 28 • BP - 88/50 ABG results are: • pH - 7.31 • HCO 3 - - 25 mEq/l • PaCO 2 - 28 mm Hg • PaO 2 - 99 mm Hg The most probable origin of the acid-base imbalance is the absence of food for 2 days which stimulates excess production of acid.

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