The nurse admits a client in the ED and performs an arterial blood gas. The results are pH: 7.51, PCO2: 49, PO2: 85, and HCO3: 35. Which of the following describes this ABG result?
• Partially compensated metabolic alkalosis is correct because there is an increase in pH (alkalosis) and an increase in HCO3 (indicating that the cause has to be metabolic in origin).
• PCO2 is also elevated, which tells us the lungs are attempting to compensate by retaining CO2 via decreasing respirations (but have not yet fully compensated.)
• Respiratory system is the cause
• Increase in PCO2,
• Compensation - Kidneys reabsorb Bicarb (HCO3)
• Caused by loss of bicarb or a buildup of acids (lactic acidosis, diarrhea, renal failure, ketones, ammonium intoxication) Not caused by respiration.
• HCO3 decreases, pH decreases
• Compensation - hyperventilation to eliminate CO2
• Caused by excessive ventilation
• Decrease in PCO2,
• Compensation - Kidneys excrete HCO3
• Acid (H+) lost from emesis, diuretics. Retention of HCO3 from medications, hyperaldosteronism
• Increase in HCO3, Increase in pH
• Compensation - Respiratory centers are not stimulated, which leads to hypoventilation and CO2 retention.