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NCLEX Question of the Day
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A client with a history of Chronic Obstructive Pulmonary Disease (COPD) is admitted with increasing dyspnea and cough. Arterial blood gas (ABG) results show: pH 7.28, PaCO2 65 mmHg, PaO2 55 mmHg, HCO3- 28 mEq/L. How should the nurse interpret these results?
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Fully compensated respiratory acidosis
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Uncompensated respiratory acidosis
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Correct answer Partially compensated respiratory acidosis
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Compensated metabolic alkalosis
Rationale
To interpret ABGs: 1. Check pH: 7.28 is acidotic (normal 7.35-7.45). 2. Check PaCO2: 65 mmHg is high (acidic, normal 35-45 mmHg), indicating a respiratory cause. 3. Check HCO3-: 28 mEq/L is high (alkaline, normal 21-28 mEq/L), indicating metabolic compensation. Since the PaCO2 matches the acidosis (respiratory acidosis) and the HCO3- is elevated (attempting to compensate), it is respiratory acidosis with metabolic compensation. Because the pH (7.28) is still outside the normal range (not yet corrected to 7.35-7.45), the compensation is partial. Uncompensated would have a normal HCO3-. Fully compensated would have an abnormal PaCO2 and HCO3- but a normal pH.
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