Acid Base and Beyond

Question 1

pH 7.64, PaCO2 25, HCO3- 19

Answer 1

Respiratory Alkalosis, Partially Compensated

Question 2

pH 7.5, PaCO2 19, HCO3- 22

Answer 2

Respiratory Alkalosis, Uncompensated

Question 3

A patient involved in an MVC is in a state of emotional distress. He feels dizzy, tingling in his fingertips, and does not remember what happened to his car. RR- 34. Which primary acid-base disturbance is likely?

Answer 3

Respiratory Alkalosis

Question 4

The ABG: pH 7.35, PaCO2 72 mmHg, and HCO3 38 mEq/L.

Answer 4

Compensated Respiratory Acidosis

Question 5

pH 7.57, PaCO2 22, HCO3- 17

Answer 5

Respiratory Alkalosis, Partially Compensated

Question 6

pH 7.6, PaCO2 53, HCO3- 38

Answer 6

Metabolic Alkalosis, Partially Compensated

Question 7

pH 7.55, PaCO2 25, HCO3- 22

Answer 7

Respiratory Alkalosis, Uncompensated

Question 8

pH 7.34, PaCO2 24, HCO3- 20

Answer 8

Metabolic Acidosis, Partially Compensated

Question 9

A patient reports coffee ground emesis and is lethargic.
ABG: pH 7.57, PaCO2 37 mmHg, and HCO3 30 mEq/L.

Answer 9

Metabolic Alkalosis

Question 10

pH 7.45, PaCO2 50, HCO3- 30

Answer 10

Metabolic Alkalosis, Fully Compensated

Question 11

A patient was drinking beer at a party, fell, and hit their head. HR- 110, RR- 8 and shallow, and is profusely bleeding from both ears. Which primary acid-base imbalance is likely?

Answer 11

Metabolic Acidosis

Question 12

A patient is anxious and scared. He begins to hyperventilate and becomes very dizzy. ABG: pH 7.61, PaCO2 22 mmHg, and HCO3 25 mEq/L.

Answer 12

Respiratory Alkalosis

Question 13

A mountaineer climbs a mountain and reaches an altitude of 16,400 ft above sea level. Which primary acid-base disturbance is likely?

Answer 13

Respiratory Alkalosis

Question 14

An infant has been irritable, difficult to breastfeed, and has had diarrhea for the x 3 days. RR- 40 and the fontanels are sunken.
ABG: pH 7.39, PaCO2 27 mmHg, and HCO3 19 mEq/L.

Answer 14

Compensated Metabolic Acidosis

Question 15

A patient has experienced persistent vomiting for two days. They appear to be lethargic and weak and has myalgia.
ABG: pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L.

Answer 15

Metabolic Alkalosis

Question 16

pH 7.39, PaCO2 44, HCO3- 26

Answer 16

Normal

Question 17

pH 7.17, PaCO2 48, HCO3- 36

Answer 17

Respiratory Acidosis, Partially Compensated

Question 18

A patient is found comatose, having taken an unknown number of sleeping pills. pH 6.90, HCO3- 13 meq/liter, and PaCO2 68 mmHg.

Answer 18

Respiratory and Metabolic Acidosis

Question 19

A 54-year-old with a history of COPD and increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum x 3 days. HR: 112, RR 24, LS- crackles and wheezes in the lower lobes. ABG: pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg.

Answer 19

Partially Compensated Respiratory Acidosis

Question 20

A 6-year-old at an urgent care has been vomiting, nauseated, and has overall weakness. K+- 2.9 mEq. Which primary acid-base imbalance is likely?

Answer 20

Metabolic Alkalosis

Question 21

A patient admits that her mother has taken many tablets of aspirin over the last 24-hour period because of a severe headache. HR- 95, RR- 32, deep. Which primary acid-base imbalance is likely?

Answer 21

Metabolic Acidosis

Question 22

A patient is difficult to arouse two hours following outpatient surgery. HR- 60, RR- 7.
ABG: pH 7.10, PaCO2 70 mm Hg, and HCO3 24 mEq/L.

Answer 22

Respiratory Acidosis

Question 24

An elementary student was rushed to the hospital due to vomiting and a decreased level of consciousness. The patient displays slow and deep breathing. He has a two-week history of polydipsia, polyuria, and weight loss.
ABG: pH 7.0, PaO2 90 mm Hg, PaCO2 23 mm Hg, and HCO3 12 mmol/L.

Answer 24

partially Compensated Metabolic Acidosis

Question 25

A patient fell to the ground and hurt her left leg. HR-123. RR- 26. Suddenly, she started complaining that she is still in pain and experiencing muscle cramps, tingling, and paraesthesia.
ABG: pH 7.6, PaO2 120 mm Hg, PaCO2 31 mm Hg, and HCO3 25 mmol/L.

Answer 25

Respiratory Alkalosis

Question 26

High CO2 increases/decreases the affinity of Hgb for O2. Referred to as the ____ effect, causing a right/ left shift of the oxyhemoglobin curve.

Answer 26

decreases
Bohr
right

Question 27

Name (1) type of patient are you likely to find this waveform (Phase 4)?

Answer 27

Due to poor compliance, atelectasis- These patients progress quickly from respiratory distress to respiratory failure:

Pregnant
Obese
Severe pulmonary edema

Question 28

Which burns more deeply causing liquification necrosis:
Acid
Alkali

Answer 28

Alkali