Imbalance - Acid-Base: Questions With Expert Verified
Answers
normal pH Right Ans - 7.35-7.45
normal PaCO₂ Right Ans - 35-45 mm Hg
normal HCO₃ Right Ans - 22-26 mEq/L (MS text, Fund text, IV book, Hurst)
21-28 mEq/L (NCLEX, ATI)
normal PaO₂ Right Ans - ≥80 mm Hg
Arrows indicating changes in ABGs for respiratory acidosis (uncompensated):
-pH
-PaCO₂
-HCO₃ Right Ans - -pH ↓
-PaCO₂ ↑
-HCO₃ ↔
Arrows indicating changes in ABGs for metabolic acidosis (uncompensated):
-pH
-PaCO₂
-HCO₃ Right Ans - -pH ↓
-PaCO₂ ↔
-HCO₃ ↓
Arrows indicating changes in ABGs for respiratory alkalosis
(uncompensated):
-pH
-PaCO₂
-HCO₃ Right Ans - -pH ↑
-PaCO₂ ↓
-HCO₃ ↔
Arrows indicating changes in ABGs for metabolic alkalosis (uncompensated):
-pH
-PaCO₂
-HCO₃ Right Ans - -pH ↑
,-PaCO₂ ↔
-HCO₃ ↑
uncompensated Right Ans - -pH is outside the expected reference range
-either the PaCO₂ or HCO₃ is outside the expected reference range
partially compensated Right Ans - pH, PaCO₂, and HCO₃ are all outside the
expected reference range
fully compensated Right Ans - -pH is within the expected reference range
-PaCO₂ and HCO₃ are both outside the expected reference range
respiratory acidosis cause Right Ans - hypoventilation:
-respiratory/CNS depression (ex: opioids, sedatives)
-respiratory disease (ex: COPD, asthma)
-neurological problems (ex: brain tumor, trauma)
respiratory alkalosis cause Right Ans - hyperventilation:
-anxiety, fear
-pain
-neurological problems (ex: stroke, meningitis, trauma)
metabolic acidosis causes (5) Right Ans - -ketoacidosis (DKA)
-diarrhea
-renal failure
-malnutrition, starvation
-salicylate overdose (aspirin)
metabolic alkalosis causes (4) Right Ans - loss of acid, too much base:
-vomiting
-NG suctioning
-hypokalemia
-antacid overdose
metabolic acidosis is associated with which electrolyte imbalance? Right
Ans - hyperkalemia (e.g. DKA)
metabolic alkalosis is associated with which electrolyte imbalance? Right
Ans - hypokalemia
, A client is experiencing respiratory alkalosis as a result of hyperventilation.
The nurse would expect the blood gas values to reflect what changes?
1. Decreased pH, decreased PCO₂
2. Decreased pH, increased PCO₂
3. Increased pH, decreased PCO₂
4. Increased pH, increased PCO₂ Right Ans - 3. Increased pH, decreased
PCO₂
(respiratory alkalosis)
Critical Thinking
A nurse is obtaining arterial blood gases for a client who has vomited for 24
hr. The nurse should expect which of the following acid-base imbalances to
result from vomiting for 24 hr?
a. respiratory acidosis
b. respiratory alkalosis
c. metabolic acidosis
d. metabolic alkalosis Right Ans - d. metabolic alkalosis
(excessive vomiting causes a loss of gastric acids and an accumulation of
bicarbonate in the blood)
ATI
A nurse is assessing a client who has pancreatitis. The client's arterial blood
gases reveal metabolic acidosis. Which of the following are expected findings?
(Select all that apply)
a. tachycardia
b. hypertension
c. bounding pulses
d. hyperreflexia
e. dysrhythmia
f. tachypnea Right Ans - e. dysrhythmia
f. tachypnea
-tachycardia = respiratory acidosis or metabolic alkalosis
-hypertension = respiratory acidosis
Answers
normal pH Right Ans - 7.35-7.45
normal PaCO₂ Right Ans - 35-45 mm Hg
normal HCO₃ Right Ans - 22-26 mEq/L (MS text, Fund text, IV book, Hurst)
21-28 mEq/L (NCLEX, ATI)
normal PaO₂ Right Ans - ≥80 mm Hg
Arrows indicating changes in ABGs for respiratory acidosis (uncompensated):
-pH
-PaCO₂
-HCO₃ Right Ans - -pH ↓
-PaCO₂ ↑
-HCO₃ ↔
Arrows indicating changes in ABGs for metabolic acidosis (uncompensated):
-pH
-PaCO₂
-HCO₃ Right Ans - -pH ↓
-PaCO₂ ↔
-HCO₃ ↓
Arrows indicating changes in ABGs for respiratory alkalosis
(uncompensated):
-pH
-PaCO₂
-HCO₃ Right Ans - -pH ↑
-PaCO₂ ↓
-HCO₃ ↔
Arrows indicating changes in ABGs for metabolic alkalosis (uncompensated):
-pH
-PaCO₂
-HCO₃ Right Ans - -pH ↑
,-PaCO₂ ↔
-HCO₃ ↑
uncompensated Right Ans - -pH is outside the expected reference range
-either the PaCO₂ or HCO₃ is outside the expected reference range
partially compensated Right Ans - pH, PaCO₂, and HCO₃ are all outside the
expected reference range
fully compensated Right Ans - -pH is within the expected reference range
-PaCO₂ and HCO₃ are both outside the expected reference range
respiratory acidosis cause Right Ans - hypoventilation:
-respiratory/CNS depression (ex: opioids, sedatives)
-respiratory disease (ex: COPD, asthma)
-neurological problems (ex: brain tumor, trauma)
respiratory alkalosis cause Right Ans - hyperventilation:
-anxiety, fear
-pain
-neurological problems (ex: stroke, meningitis, trauma)
metabolic acidosis causes (5) Right Ans - -ketoacidosis (DKA)
-diarrhea
-renal failure
-malnutrition, starvation
-salicylate overdose (aspirin)
metabolic alkalosis causes (4) Right Ans - loss of acid, too much base:
-vomiting
-NG suctioning
-hypokalemia
-antacid overdose
metabolic acidosis is associated with which electrolyte imbalance? Right
Ans - hyperkalemia (e.g. DKA)
metabolic alkalosis is associated with which electrolyte imbalance? Right
Ans - hypokalemia
, A client is experiencing respiratory alkalosis as a result of hyperventilation.
The nurse would expect the blood gas values to reflect what changes?
1. Decreased pH, decreased PCO₂
2. Decreased pH, increased PCO₂
3. Increased pH, decreased PCO₂
4. Increased pH, increased PCO₂ Right Ans - 3. Increased pH, decreased
PCO₂
(respiratory alkalosis)
Critical Thinking
A nurse is obtaining arterial blood gases for a client who has vomited for 24
hr. The nurse should expect which of the following acid-base imbalances to
result from vomiting for 24 hr?
a. respiratory acidosis
b. respiratory alkalosis
c. metabolic acidosis
d. metabolic alkalosis Right Ans - d. metabolic alkalosis
(excessive vomiting causes a loss of gastric acids and an accumulation of
bicarbonate in the blood)
ATI
A nurse is assessing a client who has pancreatitis. The client's arterial blood
gases reveal metabolic acidosis. Which of the following are expected findings?
(Select all that apply)
a. tachycardia
b. hypertension
c. bounding pulses
d. hyperreflexia
e. dysrhythmia
f. tachypnea Right Ans - e. dysrhythmia
f. tachypnea
-tachycardia = respiratory acidosis or metabolic alkalosis
-hypertension = respiratory acidosis
