Strong opioids are most likely to cause which acid-base disturbance? Question 15 options: Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis
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Strong opioids, such as morphine and fentanyl, can depress the central nervous system, leading to decreased respiratory rate and depth. Show more…
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Metabolic Acidosis Metabolic Alkalosis Respiratory Acidosis Respiratory Alkalosis 1. decreased blood level of CO2 as a result of hyperventilation 2. decreased respiratory rate in a patient taking an overdose of morphine 3. excessive intake of antacids 4. prolonged vomiting of stomach contents which are high in HCl content 5. ketosis in uncontrolled diabetes mellitus 6. decreased respiratory minute volume in a patient with emphysema or fractured rib 7. excessive loss of bicarbonate from the body as in prolonged diarrhea
Madhur L.
Use the arterial blood data provided for each patient to make a complete diagnosis: i. Acidosis or alkalosis ii. Respiratory or metabolic iii. Uncompensated, partially compensated, or fully compensated iv. Hyperoxia, normal oxygen, mild, moderate or severe hypoxemia v. All values are normal A patient with a long history of COPD entered the hospital with labored breathing. His room air arterial blood gases were: pH = 7.23, PCO2 = 67 mmHg, HCO3- = 26 mEq/L and PO2 = 40 mmHg. Another patient with a history of COPD entered the hospital with labored breathing. Her room air arterial blood gases were: pH = 7.39, PCO2 = 67 mmHg, HCO3- = 40 mEq/L and PO2 = 44 mmHg. A 17 year old diabetic was admitted to the ER with Kussmaul breathing. Her room air arterial blood gases were: pH = 7.02, PCO2 = 24, mmHg, HCO3- = 6 mEq/L and PO2 = 99 mmHg. A 45 year old man without previous illness entered the coronary care unit with an EKG diagnosis of "posterior wall infarct" and severe chest pain. His room air arterial blood gases were: pH = 7.51, PCO2 = 30 mmHg, HCO3- = 22 mEq/L and PO2 = 64 mmHg. A 21 year old woman entered the ER with uncontrolled diabetes mellitus. She was hyperventilating. She was given insulin and sometime later an arterial blood sample was drawn yielding: pH = 7.39, PCO2 = 28 mmHg, HCO3- = 15 mEq/L and PO2 = 97 mmHg. Another patient who had her diabetes mellitus under control came into the ER. A room air blood gas sample gave the results: pH = 7.42, PCO2 = 40 mmHg, HCO3- = 25 mEq/L and PO2 = 98 mmHg. A 24 year old patient was admitted to the ER complaining of nausea, vomiting and abdominal cramps for the past 48 hrs. He was found to have an intestinal obstruction and was taken to surgery. His room air arterial blood gases were: pH = 7.63, PCO2 = 40 mmHg, HCO3- = 41 mEq/L and PO2 = 95 mmHg.
Adi S.
Key choices: A. Metabolic acidosis B. Metabolic alkalosis C. Normal range D. Respiratory acidosis E. Respiratory alkalosis Statements: 1. Indicated by plasma HCO3 levels above the normal range. 2. Pco2 = 35-45 mm Hg; pH 7.35-7.45. 3. Indicated by plasma Pco2 levels above the normal range. 4. A common cause is excess HCO3 loss resulting from prolonged diarrhea. 5. Imbalance where HCO3 levels are high; compensated by slow, shallow breathing (therefore high Pco2)
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