You are an ICU nurse caring for a trauma patient. The patient is complaining of having trouble breathing with abdominal pain. An ABG reveals the following results: pH 7.28, PaCO2 50 mm Hg, HCO3- 23 mEq/L
What would you know is happening with this patient?
A) Respiratory acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis
D) Mixed acid-base disorder
Ans: D
Feedback: Patients can simultaneously experience two or more independent acid–base disorders. A normal pH in the presence of changes in the PaCO2 and plasma HCO3– concentration immediately suggests a mixed disorder, making options A, B, and C incorrect. An example of a mixed disorder is the simultaneous occurrence of metabolic acidosis and respiratory acidosis during respiratory and cardiac arrest. The only mixed disorder that cannot occur is a mixed respiratory acidosis and alkalosis because it is impossible to have alveolar hypoventilation and hyperventilation at the same time.
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