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Acid/Base Balance Content Post Test- HURST Questions and Answers
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Acid/Base Balance Content Post Test- HURST Questions and Answers How would the nurse interpret this client's Arterial Blood Gas (ABG) results? pH 7.30 PaCO2 55 mm Hg Bicarb 25 mEq/liter PaO2 93 mm Hg SaO2 95% Select All That Apply 1. Respiratory acidosis 2. Respiratory alkalosis 3. Me...

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  • October 2, 2024
  • 7
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • acidbase balance content post test hurst questio
  • how would the nurse interpret this clients arteri
  • the emergency department nurse is monitoring a cli

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Acid/Base Balance Content Post Test-
HURST Questions and Answers
How would the nurse interpret this client's Arterial Blood Gas (ABG) results?

pH 7.30
PaCO2 55 mm Hg
Bicarb 25 mEq/liter
PaO2 93 mm Hg
SaO2 95%

Select All That Apply
1. Respiratory acidosis
2. Respiratory alkalosis
3. Metabolic acidosis
4. Metabolic alkalosis
5. Uncompensated
6. Partially compensated
7. Fully compensated - answer 1, 5

Rationale
1., & 5. Correct. Now will a pH of 7.30 make the patient have acidosis or alkalosis? Well
it's less than 7.35 so that's a low pH, and you know that a low pH is acidosis. So now
we know acidosis, but we still must figure out if it is respiratory or metabolic. Look at the
PaCO2, it is 55. That's a lot of CO2, and it's greater than the normal range of 35-45, so
the PaCO2 must be acidosis. Now the Bicarb is 25, and a Bicarb of 25 is within the
normal range of 22-26. To determine whether this is respiratory or metabolic acidosis,
we need to match the pH with either the PaCO2 or the HCO3. The pH that we're trying
to match is acidosis, so keep in mind you're trying to match the word acidosis with one
of the chemicals.
Well look at our problem, the CO2 is also acidosis. So, since these two match and they
are both acidosis, we can say this is clearly Respiratory Acidosis because the
"respiratory" chemical (CO2) is the one that matches the pH. Now, look at the Bicarb
level. The bicarb is normal and doesn't match our pH which is acidosis, so, we can just
mark it out.
There you have it; this is Respiratory Acidosis. So, is there any compensation going on?
No, not yet. The bicarb is still within normal limits. These values indicate
uncompensated respiratory acidosis.
2. Incorrect. The pH would need to be above 7.45 and the PaCO2 below 35 for the
client to have respiratory alkalosis.
3. Incorrect. The pH would need to be below 7.35 and the Bicarb below 22 for the client
to have metabolic acidosis.

, 4. Incorrect. The pH would need to be above 7.45 and the Bicarb above 26 for the client
to have metabolic alkalosis.
6. Incorrect. When partial compensation begins, the bicarb level will be above 26 as it
goes UP to put more base in the body.
7. Incorrect. Full compensation will occur when the pH comes back to normal.

The emergency department nurse is monitoring a client being admitted in diabetic
ketoacidosis (DKA). Which arterial blood gas value would be expected?
Select All That Apply
1. pH 7.32
2. PaCO2 32
3. HCO3 25
4. PaO2 78
5. SaO2 82 - answer 1, 2

Rationale
1., &2. Correct: In DKA, the client is acidotic. Normal pH is 7.35-7.45. A pH of 7.32
indicates acidosis and will be expected for a client in DKA. Normal PaCO2 is 35-45.
Remember CO2 is considered an acid. The client in DKA will have an increased
respiratory rate, so the PaCO2 will either be normal or low. This value of 32 is low and
is an expected finding as the body is compensating for the acidosis.
3. Incorrect: Normal HCO3 is 22-26. HCO3 is a base. Initially, the acids bind to the
bicarb to reduce the acid levels. Therefore, the HCO3 would be less than 22. So, in
DKA, the expected initial finding is a low HCO3?. Keep in mind that with acidosis, as the
body compensates later, the kidneys will retain bicarb and you will see the bicarb levels
increase.
4. Incorrect: Normal PaO2 is 80-100. An expected finding in DKA will be normal or
increased PaO2, not decreased.
5. Incorrect: The client in DKA is kussmauling to blow off the CO2 (acid), so the oxygen
saturation of blood will be high if there is no respiratory issue. In this question you are
not told that there is a respiratory problem, so you would not expect a low oxygen
saturation level.

A client, admitted to the surgical unit post left thoracotomy, is drowsy. Vital signs on
admit are T 99.8ºF (37.6ºC), HR 94, R 16/shallow, BP 100/68. ABGs are pH 7.33,
PCO2 48, HCO3 24. What action should the nurse initiate?
Choose One
1. Have client take deep breaths.
2. Administer naloxone.
3. Tell the client to breathe faster.
4. Medicate for pain. - answer 1

Rationale
1. Correct: This client had chest surgery and the pCO2 is high. What are you worried
about? Hypoventilation. Yes, the client is probably hurting due to the incision and does
not want to take deep breaths. In order to get rid of the excess CO2 the client needs to

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