Can anyone help solve this question and also give reasoning with it?
A 45-year-old woman is brought to the physician after she was found to have nausea, fever, and upper abdominal discomfort. Her
medical problems include severe depression, migraine, and rheumatoid arthritis. The patient describes severe tinnitus and vertigo
She admits that she overdosed on one of her medications several hours ago. Her temperature is 38 1 C (100.5 F), blood pressure is
120/76 mm Hg, pulse is 115/min, and respirations are 26/min. Physical examination is otherwise unremarkable. Which of the following acid-base findings is most likely to be present on arterial blood gas analysis?
pH. PaCO, (mm Hg) HCOi. (mEq/L)
A. 7.30. 27. 13
B.7.32. 50. 25
C.7.39. 20. 12
D.7.40. 40. 24
E.7.42. 54. 32
To determine the acid-base findings on arterial blood gas (ABG) analysis for this patient, we need to understand the normal ranges for pH, PaCO2 (partial pressure of carbon dioxide), and HCO3- (bicarbonate).
In this scenario, the patient is experiencing nausea, fever, upper abdominal discomfort, tinnitus, and vertigo. She also overdosed on one of her medications. Examining her vital signs, she has a high pulse rate (115/min) and an increased temperature (38.1°C or 100.5°F), indicating possible physiological distress.
When interpreting ABG results, we need to consider the pH first. The normal range for pH is between 7.35-7.45, which indicates acid-base balance. Deviations from this range indicate an acidotic (acidemia, pH < 7.35) or alkalotic (alkalemia, pH > 7.45) state.
Now, let's analyze the options given:
A. pH 7.30, PaCO2 27 mm Hg, HCO3- 13 mEq/L
B. pH 7.32, PaCO2 50 mm Hg, HCO3- 25 mEq/L
C. pH 7.39, PaCO2 20 mm Hg, HCO3- 12 mEq/L
D. pH 7.40, PaCO2 40 mm Hg, HCO3- 24 mEq/L
E. pH 7.42, PaCO2 54 mm Hg, HCO3- 32 mEq/L
We can quickly rule out options A and C since the pH is below the normal range, indicating acidemia. Since the patient has been experiencing symptoms, it's reasonable to assume an acid-base disorder is present.
Next, we analyze options B, D, and E:
B. pH 7.32, PaCO2 50 mm Hg, HCO3- 25 mEq/L -> The pH is still lower than the normal range, indicating acidemia. However, the PaCO2 and HCO3- levels are within the normal ranges. This is consistent with a respiratory acidosis, where the PaCO2 is elevated due to inadequate ventilation or impaired gas exchange.
D. pH 7.40, PaCO2 40 mm Hg, HCO3- 24 mEq/L -> The pH is within the normal range, and both the PaCO2 and HCO3- levels are also within the normal ranges. This indicates a normal acid-base balance (compensated).
E. pH 7.42, PaCO2 54 mm Hg, HCO3- 32 mEq/L -> The pH is higher than the normal range, indicating alkalemia. The elevated PaCO2 and HCO3- levels suggest a metabolic alkalosis, where there is an excess of bicarbonate in the blood.
Based on the reasoning above, the correct answer is D. The patient's acid-base findings on arterial blood gas analysis are pH 7.40, PaCO2 40 mm Hg, and HCO3- 24 mEq/L, which represent a compensated normal acid-base balance.