Question

A nurse is reviewing the ABG results for four clients. Which of the following findings should the nurse identify as metabolic acidosis?

a. pH 7.51, PaO2 94 mmHg, PaCO2 38 mmHg, HCO3- 29 mEq/L
b. pH 7.48, PaO2 89 mmHg, PaCO2 30 mmHg, HCO3- 24 mEq/L
c. pH 7.36, PaO2 77 mmHg, PaCO2 52 mmHg, HCO3- 26 mEq/L
d. pH 7.26, PaO2 84 mmHg, PaCO2 38 mmHg, HCO3- 20 mEq/L

Answer 1

The blood gas results that indicate metabolic acidosis are a pH of 7.26 and an HCO3- of 20 mEq/L, with a PaCO2 of 38 mmHg, which falls within the normal range indicating no significant respiratory compensation.

Step-by-step explanation:

The client's blood gas results that indicate metabolic acidosis are: pH 7.26, PaO2 84 mmHg, PaCO2 38 mmHg, HCO3- 20 mEq/L. Metabolic acidosis is characterized by a low pH and a low HCO₃- level. In this case, the pH is below the normal range (7.35 to 7.45), and the HCO3- level is also below the normal range of 22-29 mEq/L. These findings are consistent with metabolic acidosis. Normal PaCO2 ranges are 35-48 mm Hg for males and 32-45 mm Hg for females, which indicates that there's no significant respiratory compensation, as the PaCO2 is normal. Therefore, the correct option is d, which demonstrates a primary metabolic acidosis.