Question

A nurse is caring for a client who is postoperative and has a respiratory rate of 9/min secondary to general anesthesia effects and incisional pain. Which of the following ABG values indicates the client is experiencing respiratory acidosis?

A. pH 7.50, PO2 95 mm Hg, PaCO2 25 mmHg, HCO3- 22 mEq/L
B. pH 7.50, PO2 87 mm Hg, PaCO2 35 mmHg, HCO3- 30 mEq/L
C. pH 7.30, PO2 90 mm Hg, PaCO2 35 mmHg, HCO3- 20 mEq/L
D. pH 7.30, PO2 80 mmHg, PaCO2 55 mmHg, HCO3- 22 mEq/L

Answer 1

The ABG values that suggest respiratory acidosis are a pH of 7.30, a PaCO2 of 55 mmHg, and an HCO3- of 22 mEq/L, with the elevated PaCO2 indicating retention of CO2 due to hypoventilation.

Step-by-step explanation:

The client's arterial blood gas (ABG) values that indicate they are experiencing respiratory acidosis are a pH of 7.30, partial pressure of CO2 (PaCO2) at 55 mmHg, and bicarbonate (HCO3-) at 22 mEq/L. These values indicate an acidotic state because the pH is below the normal range of 7.35-7.45.

Furthermore, the elevated PaCO2 above the normal range of 35-45 mmHg for females and 35-48 mmHg for males suggests that the patient's respiratory system is retaining CO2, commonly caused by hypoventilation, which can be due to the effects of general anesthesia or incisional pain postoperatively. The bicarbonate level is within the normal range of 22-29 mEq/L, suggesting there hasn't been significant renal compensation. The control of blood carbonic acid levels through the respiratory system involves adjusting the respiratory rate to manage CO2 levels, which affects the pH status of the blood.

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