A homeless client is brought into the emergency department with indications of extremely poor nutrition. Arterial blood gas levels are assessed, and the nurse anticipates that this client will demonstrate which of the following results?
1. pH 7.3, PaCO2 38 mm Hg, HCO3 19 mEq/L
2. pH 7.5, PaCO2 34 mm Hg, HCO3 20 mEq/L
3. pH 7.35, PaCO2 35 mm Hg, HCO3 24 mEq/L
4. pH 7.52, PaCO2 48 mm Hg, HCO3 28 mEq/L
ANS: 1
Metabolic acidosis may be found in cases of starvation. The client's pH is below the normal of 7.35 (at 7.3), the PaCO2 is in the normal range of 35 to 45 mm Hg (at 38 mm Hg), and the HCO3 is below the normal of 22 mEq/L (at 19 mEq/L). These findings demonstrate metabolic acidosis. Values of pH 7.5, PaCO2 34 mm Hg, HCO3 20 mEq/L are consistent with respiratory alkalosis, compensated, which would not be typical of malnutrition. Values of pH 7.52, PaCO2 48 mm Hg, HCO3 28 mEq/L are consistent with metabolic alkalosis, compensated, which would not be an expected finding with extremely poor nutrition.
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