The nurse is determining if a patient has a mixed acid-base disorder. Which of the following would indicate such a disorder?
1. pH 7.5, HCO3 36 mEq/L
2. pH 7.2, PaCO2 65 mm Hg
3. pH 7.5, HCO3 23 mEq/L
4. pH 7.45, PcCO2 30 mm Hg
3
Rationale: If the acid–base problem is purely metabolic, a pH change of 0.15 will result in a corresponding change in HCO3 of approximately10 mEq/L. The patient with a pH of 7.5 and a corresponding HCO3 level of 23 mEq/L indicates a mixed acid-base disorder is present. The other choices indicate either a pure respiratory or metabolic disorder.
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