Question

A 39-week gestational age infant is receiving supplemental oxygen by oxyhood. An air/oxygen blender is set at 30% and the heated large volume aerosol is set at 100%. A capillary blood sample reveals the following values:

pH 7.30 PcCO2 49 torr
PcO2 48 torr
HCO3- 23 mEq/L
BE -1 mEq/L
SpO2 97%
Which of the following is an accurate interpretation of this data?
A. hypoventilation and respiratory acidosis
B. hypoxemia and respiratory acidosis
C. acute-on-chronic metabolic acidosis
D. metabolic alkalosis with mild hypoxemia

Answer 1

The capillary blood sample values for the infant indicate hypoventilation and respiratory acidosis, with a slightly elevated PcCO2 and a normal HCO3- level which does not compensate for the acidosis, and an SpO2 level that shows adequate oxygenation.

Step-by-step explanation:

An interpretation of the capillary blood sample values for a 39-week gestational age infant receiving supplemental oxygen is needed, with values of pH 7.30, PcCO2 49 torr, PcO2 48 torr, HCO3- 23 mEq/L, BE -1 mEq/L, and SpO2 97%. Looking at Table 26.3, which provides reference values, the interpretation should be based on whether the data indicates acidosis or alkalosis and whether it is of a metabolic or respiratory origin.

The infant's pH is lower than the normal range of 7.35-7.45, indicating acidemia. The PcCO2 level is slightly higher than the standard reference range for males (35-48 mm Hg) and females (32-45 mm Hg), suggesting hypoventilation and respiratory acidosis. The HCO3- level is within the normal range (22-29 mEq/L), showing no signs of compensation for the acidosis. SpO2 at 97% does not indicate hypoxemia; rather, it shows adequate oxygenation of the blood. Therefore, the most accurate interpretation of this data is A. hypoventilation and respiratory acidosis.