Which of the following arterial blood gas (ABG) values indicates uncompensated metabolic alkalosis?
A. pH 7.48, PaCO2 42, HCO3 30
B. pH 7.48, PaCO2 46, HCO3 30
C. pH 7.48, PaCO2 34, HCO3 20
D. pH 7.48, PaCO2 34, HCO3 26
Correct Answer: A. pH 7.48, PaCO2 42, HCO3 30
Uncompensated metabolic alkalosis is indicated by ABG values of pH 7.48, PaCO2 42, and HCO3 30. Normal human physiological pH is 7.35 to 7.45. A decrease in pH below this range is acidosis, an increase over this range is alkalosis. Metabolic alkalosis is defined as a disease state where the body’s pH is elevated to greater than 7.45 secondary to some metabolic process.
Option B: These values indicate metabolic alkalosis, partially compensated. HCO3 functions as an alkalotic substance. CO2 functions as an acidic substance. Therefore, increases in HCO3 or decreases in CO2 will make blood more alkalotic. The opposite is also true where decreases in HCO3 or an increase in CO2 will make blood more acidic. CO2 levels are physiologically regulated by the pulmonary system through respiration, whereas the HCO3 levels are regulated through the renal system with reabsorption rates.
Option C: These values indicate respiratory alkalosis, partially compensated. Respiratory alkalosis is 1 of the 4 basic classifications of blood pH imbalances. Normal human physiological pH is 7.35 to 7.45. A decrease in pH below this range is acidosis, an increase above this range is alkalosis. Respiratory alkalosis is by definition a disease state where the body’s pH is elevated to greater than 7.45 secondary to some respiratory or pulmonary process.
Option D: These values indicate respiratory alkalosis, uncompensated. If the pH is not within or close to the normal ranges, then a partial compensation exists. If the pH is back within normal ranges then a full compensation has occurred. A non-compensated or uncompensated abnormality usually represents an acute change occurring in the body.
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