A 21-year-old male is brought to the ED due to overdose of heroin. His respiratory rate is 5-6 and he is unresponsive. Prior to administration of naloxone, an arterial blood gas is obtained. The nurse anticipates which of the following results?

pH: 7.28, PCO2: 60, HCO3: 26


•Because the client was hypoventilating, PCO2 will be elevated due to C02 retention, causing respiratory acidosis. The bicarb level should be normal because the kidneys would not have had time to compensate.

Respiratory Acidosis:
• Respiratory system is the cause, for ex. hypoventilation
• Increase in PCO2, decrease in pH
• Compensation - Kidneys reabsorb Bicarb (HCO3)

Metabolic Acidosis:
• Caused by loss of bicarb or a buildup of acids, for ex. lactic acidosis, diarrhea, renal failure, ketones, ammonium intoxication. Not caused by respiration.
• HCO3 decreases, pH decreases
• Compensation - hyperventilation to eliminate CO2

Respiratory Alkalosis:
• Caused by excessive ventilation
• Decrease in PCO2, increase in pH
• Compensation - Kidneys excrete HCO3

Metabolic Alkalosis:
• Acid (H+) lost from emesis, diuretics. Retention of HCO3 from medications, hyperaldosteronism.
• Increase in HCO3, Increase in pH
• Compensation - Respiratory centers are not stimulated, this leads to hypoventilation and CO2 retention.

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