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Chapter 19: Problem 21

A nurse checks the client's arterial blood gas results which are as follows: \(\mathrm{pH}, 7.38 ; \mathrm{PO}_2, 88 \mathrm{~mm} \mathrm{Hg} ; \mathrm{PCO}_2\), \(33 \mathrm{~mm} \mathrm{Hg} ; \mathrm{HCO}_3, 24 \mathrm{mEq} /\); and \(\mathrm{O}_2\) saturation, \(96 \%\). Which is the correct interpretation of these results? a. Metabolic acidosis b. Metabolic alkalosis c. Normal values d. Respiratory alkalosis

Short Answer

Expert verified
d. Respiratory alkalosis

Step by step solution

01

Check the pH level

First, look at the pH value. The pH value given is 7.38, which is within the normal range (7.35 to 7.45). Since the pH is within the normal range, it indicates that the blood gas is either normal or compensated.
02

Evaluate the PCO鈧� level

Next, examine the PCO鈧� (partial pressure of carbon dioxide) level. The normal range for PCO鈧� is 35 to 45 mm Hg. In this case, the PCO鈧� is 33 mm Hg, which is lower than the normal range indicating a tendency towards alkalosis due to respiratory factors.
03

Analyze the HCO鈧� level

Check the bicarbonate (HCO鈧�) level. The normal range for HCO鈧� is 22 to 26 mEq/L. In this case, the HCO鈧� is 24 mEq/L, which is within the normal range.
04

Determine the overall interpretation

Given that the pH is normal but the PCO鈧� is low, this suggests that there is a compensated respiratory alkalosis. The normal HCO鈧� indicates that there is no metabolic compensation needed.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

pH Levels
The pH level in the blood is crucial for determining the acid-base balance. It measures the hydrogen ion concentration, reflecting how acidic or basic the blood is. A normal pH range is between 7.35 and 7.45. If the pH level is below 7.35, it indicates acidosis, meaning the blood is too acidic. If the pH is above 7.45, it suggests alkalosis, where the blood is too basic. In the given exercise, the pH level is 7.38, which falls within the normal range, indicating that the blood鈥檚 acid-base balance is normal or possibly compensated.
PCO鈧� Analysis
PCO鈧�, or the partial pressure of carbon dioxide, is another important factor in arterial blood gas (ABG) interpretation. It indicates how well carbon dioxide is able to move out of the body. The normal range for PCO鈧� is 35 to 45 mm Hg. Lower levels of PCO鈧� (below 35 mm Hg) suggest respiratory alkalosis, where the body is exhaling too much CO鈧�. Higher levels (above 45 mm Hg) suggest respiratory acidosis, indicating CO鈧� retention. In the given scenario, the PCO鈧� level is 33 mm Hg, which is lower than the normal range, suggesting a tendency towards respiratory alkalosis.
HCO鈧� Levels
HCO鈧�, or bicarbonate, is a buffer that helps maintain the pH balance in your blood. The normal range for HCO鈧� is between 22 to 26 mEq/L. If the HCO鈧� level is higher than normal, it indicates metabolic alkalosis, where the blood is too basic due to a metabolic cause. If it's lower than normal, it means metabolic acidosis, where there is too much acid or not enough base in the blood. In the provided blood gas result, the HCO鈧� level is 24 mEq/L, which is within the normal range, suggesting there is no metabolic component altering the blood pH.
Respiratory Alkalosis
Respiratory alkalosis is a condition where the blood pH is elevated above 7.45 due to excessive exhalation of CO鈧�. Common causes include hyperventilation due to anxiety, fever, or other conditions. In the given case, although the pH is within the normal range at 7.38, the lower-than-normal PCO鈧� of 33 mm Hg signals that the body is excreting too much CO鈧�, suggesting respiratory alkalosis. The normal pH signifies that the condition has been compensated, typically by adjusting other components like HCO鈧�.
Compensated Blood Gas
When the body experiences an imbalance in pH due to respiratory or metabolic issues, it attempts to compensate to normalize the pH. This compensatory mechanism involves changes in either breathing rate, which affects CO鈧�, or kidney function affecting HCO鈧�. A compensated blood gas means that the pH has returned to normal levels despite underlying issues. In the provided example, the normal pH of 7.38, along with the low PCO鈧� of 33 mm Hg, indicates respiratory alkalosis. The fact that pH is within normal range suggests that compensation has occurred, typically by reducing the bicarbonate (HCO鈧�) levels to balance the low PCO鈧� and maintain a normal pH.

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