The nurse in the intensive care unit receives arterial blood gases (ABG) with a patient who is complaining of being "short of breath." The ABG has the following values: pH = 7.21, PaCO2 = 64 mm Hg, HCO3 = 24 mm Hg. The labs reflect:
A) Respiratory acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis
D) Metabolic acidosis
Ans: A
Feedback: A pH of less than 7.40, a PaCO2 greater than 40, and an HCO3 of 24 are normal; therefore, it is a respiratory acidosis. Compensation by the kidneys has not begun, which indicates this was probably an acute event. Option B is incorrect; an HCO3 of 24 is within the normal range, so it is not metabolic alkalosis. Option C is incorrect; a pH of 7.21 is an acidosis not alkalosis. Option D is incorrect; a pH of 7.21 is an acidosis. The HCO3 of 24 is within the normal range, so it is not a metabolic acidosis.
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