A patient's arterial blood gas levels indicate a pH of 7.51, PaCO2 of 40 mm Hg, PaO2 of 85 mm Hg, and HCO3 of 32 mEq/L. The patient has been vomiting. The nurse knows the patient has which imbalance?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
B
Normal arterial blood pH value is 7.35 to 7.45 (acidic is less than 7.35, and alkalotic is greater than 7.45). Metabolic alkalosis results from acid loss from the body or an increase in levels of bicarbonate. Normal range of bicarbonate (HCO3-) is 22 to 26 mEq/L. A level above 26 mEq/L indicates metabolic alkalosis. The most common causes are vomiting and gastric suction. Meta-bolic acidosis results from conditions that increase metabolic acids in the body or decrease the amount of base (bicarbonate). Diabetic ketoacidosis is a common cause of metabolic acidosis. Hypoventilation produces respiratory acidosis, which causes cerebrospinal fluid and brain cells to become acidic, thus decreasing the level of consciousness. Hyperventilation produces respiratory alkalosis, which causes cerebrospinal fluid and brain cells to become alkalotic, decreasing the level of consciousness.
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