A client presents to the emergency room with cyanosis, coughing, tachypnea, and tachycardi a. She has a history of asthma. Arterial blood gas values…

The client's arterial blood gas (ABG) results show a pH of 7.28, which is below the normal range of 7.35-7.45, indicating acidosis. The PaCO2 is 60 mmHg, which is elevated above the normal range of 35-45 mmHg. An elevated PaCO2 reflects carbon dioxide retention, which causes the blood to become more acidic. The HCO3 is 24 mEq/L, which is within the normal range of 22-26 mEq/L. Because the primary cause of the acidosis is the elevated respiratory parameter (PaCO2) and the metabolic parameter (HCO3) is normal, the condition is identified as respiratory acidosis. This is consistent with an acute asthma exacerbation leading to impaired gas exchange.

A. Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mmHg), which is the opposite of the client's findings.

C. Metabolic alkalosis is characterized by a high pH (>7.45) and a high HCO3 (>26 mEq/L); the client's pH is low and HCO3 is normal.

D. Metabolic acidosis is characterized by a low pH (<7.35) and a low HCO3 (<22 mEq/L); the client's HCO3 is within the normal range.

1. University of Kansas School of Nursing. (n.d.). ABG Interpretation. In Advanced Practice Nursing Student Resources. Retrieved from https://www.kumc.edu/school-of-nursing/son-students/abg-interpretation.html. This resource outlines the systematic approach to ABG analysis, defining respiratory acidosis as a pH 45 mmHg.

2. Harding, M. M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2020). Lewis's medical-surgical nursing: Assessment and management of clinical problems (11th ed.). Elsevier. In Chapter 16, Fluid, Electrolyte, and Acid-Base Imbalances, Table 16-11 specifies the characteristics of respiratory acidosis as decreased plasma pH, increased PaCO2, and normal or increased HCO3 depending on compensation.

3. Papadakis, M. A., & McPhee, S. J. (Eds.). (2020). Current Medical Diagnosis & Treatment 2020. McGraw-Hill Education. In Chapter 21, Acid-Base Disorders, the section on "Respiratory Acidosis" states that it is characterized by a primary increase in PCO2 and a decrease in pH, commonly caused by hypoventilation from conditions like severe asthma.

4. Johns Hopkins Medicine. (n.d.). Arterial Blood Gas. Health Library. Retrieved from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/arterial-blood-gas. This university-affiliated patient education resource provides normal values and explains that high CO2 levels make the blood too acidic.