Case Study 1
A client recovering from surgery in the post-anesthesia care unit is
difficult to arouse two hours following surgery. The nurse in the PACU
has been administering Morphine Sulfate intravenously to the client for
complaints of post-surgical pain. The client’s respiratory rate is 7 per
minute and demonstrates shallow breathing. The patient does not
respond to any stimuli! The nurse assesses the ABCs (remember Airway,
Breathing, Circulation!) and obtains ABGs STAT! The STAT results
come back from the laboratory and show:
pH = 7.15
Pa C02 = 68 mmHg
HC03 = 22 mEq/L
1. Compensated Respiratory Acidosis
2. Uncompensated Metabolic Acidosis
3. Compensated Metabolic Alkalosis
4. Uncompensated Respiratory Acidosis
Answer
The answer is #1
uncompensated respiratory acidosis
Case Study 2
An infant, three weeks old, is admitted to the Emergency Room.
The mother reports that the infant has been irritable, difficult to
breastfeed and has had diarrhea for the past 4 days. The infant’s
respiratory rate is elevated and the fontanels are sunken. The
Emergency Room physician orders ABGs after assessing the
ABCs.
The results from the ABGs come back from the laboratory and
show:
pH = 7.37
Pa C02 = 29 mmHg
HC03 = 17 mEq/L
1. Compensated Respiratory Alkalosis
2. Uncompensated Metabolic Acidosis
3 Compensated Metabolic Acidosis
4 Uncompensated Respiratory Acidosis
Answer
Answer is #3
Compensated Metabolic Acidosis
Case Study 3
A client, 5 days post-abdominal surgery, has a nasogastric tube.
The nurse notes that the nasogastric tube (NGT) is draining a
large amount (900 cc in 2hours) of coffee ground secretions.
The client is not oriented to person, place, or time. The nurse
contacts the attending physician and STAT ABGs are ordered.
The results from the ABGs come back from the laboratory and
show:
pH = 7.52
Pa C02 = 35 mmHg
HC03 = 29 mEq/L
1. Compensated Respiratory Alkalosis
2. Uncompensated Metabolic Acidosis
3. Compensated Metabolic Acidosis
4. Uncompensated Metabolic Alkalosis
Answer
Answer is #4
Uncompensated Metabolic Alkalosis
Case Study 4
A client is admitted to the hospital and is being prepared for a
craniotomy (brain surgery). The client is very anxious and
scared of the impending surgery. He begins to hyperventilate
and becomes very dizzy. The client looses consciousness and
the STAT ABGs reveal:
The results from the ABGs come back from the laboratory and
show:
pH = 7.57
Pa C02 = 26 mmHg
HC03 = 24 mEq/L
1. Compensated Metabolic Acidosis
2. Uncompensated Metabolic Acidosis
3. Uncompensated Respiratory Alkalosis
4. Uncompensated Respiratory Acidosis
Answer
The answer is #3
Uncompensated Respiratory Alkalosis
Case Study 5
A two-year-old is admitted to the hospital with a diagnosis of
asthma and respiratory distress syndrome. The father of the
infant reports to the nurse that he has observed slight tremors
and behavioral changes in his child over the past three days.
The attending physician orders routine ABGs following an
assessment of the ABCs. The ABG results are:
pH = 7.36
Pa C02 = 69 mmHg
HC03 = 36 mEq/L
1. Compensated Respiratory Alkalosis
2. Uncompensated Metabolic Acidosis
3. Compensated Respiratory Acidosis
4. Uncompensated Respiratory Alkalosis
Answer
Answer is #3
Compensated Respiratory Acidosis
Case Study 6
A young woman, drinking beer at a party, falls and
hits her head on the ground. A friend dials "911"
because the young woman is unconscious,
depressed ventilation (shallow and slow
respirations), rapid heart rate, and is profusely
bleeding from both ears.
Which primary acid-base imbalance is this young
woman at risk for if medical attention is not
provided?
1. metabolic acidosis
2. metabolic alkalosis
3. respiratory acidosis
4. respiratory alkalosis
Answer
Correct answer is #3
Respiratory Acidosis
Case Study 7
An 11-year old boy is admitted to the hospital with
vomiting, nausea and overall weakness. The nurse
notes the laboratory results: potassium: 2.9 mEq.
Which primary acid-base imbalance is this boy at
risk for if medical attention is not provided?
1. metabolic acidosis
2. metabolic alkalosis
3. respiratory acidosis
4. respiratory alkalosis
Answer
Correct Answer is #2
Metabolic Alkalosis
Case Study 8
An elderly gentleman is seen in the emergency
department at a community hospital. He admits to taking
many tablets of aspirin (salicylates) over the last 24-hour
period because of a severe headache. He complains of
an inability to urinate. His vital signs are: Temp = 98.5;
apical pulse = 92; respiration = 30 and deep.
Which primary acid-base imbalance is the gentleman at
risk for if medical attention is not provided?
1. metabolic acidosis
2. metabolic alkalosis
3. respiratory acidosis
4. respiratory alkalosis
Answer
Correct Answer is #1
Metabolic Acidosis
Case Study 9
A young man is found at the scene of an automobile accident in
a state of emotional distress. He tells the paramedics that he
feels dizzy, tingling in his fingertips, and does not remember
what happened to his car. Respiratory rate is rapid at
34/minute.
Which primary acid-base disturbance is the young man at risk
for if medical attention is not provided?
1. metabolic acidosis
2. metabolic alkalosis
3. respiratory acidosis
4. respiratory alkalosis
Answer
Correct Answer is #4
Respiratory Alkalosis
ACID BASE PARAMETERS
Respiratory PH PCO2 HCO3
Acidosis
Respiratory PH PCO2 HCO3
Alkalosis
Metabolic PH PCO2 HCO3
Acidosis
Metabolic PH PCO2 HCO3
Alkalosis