The nurse is caring for a patient admitted with the early stages of septic shock. The nurse assesses the patient to be tachypneic, with a respiratory rate of 32 breaths/min
Arterial blood gas values assessed on admission are pH 7.50, CO2 28 mm Hg, HCO3 26 . Which diagnostic study result reviewed by the nurse indicates progression of the shock state?
a. pH 7.40, CO2 40, HCO3 24
b. pH 7.45, CO2 45, HCO3 26
c. pH 7.35, CO2 40, HCO3 22
d. pH 7.30, CO2 45, HCO3 18
D
As shock progresses along the continuum, acidosis ensues, caused by metabolic acidosis, hypoxia, and anaerobic metabolism. A pH 7.30, CO2 45 mm Hg, HCO3 18 indicates metabolic acidosis and progression to a late stage of shock. All other listed arterial blood gas values are within normal limits.
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