A client arrives with lethargy and fruity breath odor. What acid-base disturbance could be indicated by a pH of 7.25 and HCO3 of 14 mEq/L?

A client arrives with lethargy and fruity breath odor. What acid-base disturbance could be indicated by a pH of 7.25 and HCO3 of 14 mEq/L?

• A. Metabolic alkalosis
• B. Respiratory acidosis
• C. Respiratory alkalosis
• D. Metabolic acidosis

Answer: (D)

The scenario presented indicates a pH of 7.25, which is below the normal range of 7.35-7.45, suggesting acidosis. Additionally, the bicarbonate (HCO3) level is measured at 14 mEq/L, which is significantly lower than the normal range of 22-28 mEq/L. These values strongly suggest a metabolic acidosis condition. In metabolic acidosis, the primary disturbance is a decrease in bicarbonate levels, which is evident in this case. The associated symptoms, such as lethargy and fruity breath odor, can indicate the presence of ketones, commonly seen in diabetic ketoacidosis, a condition that leads to metabolic acidosis due to an accumulation of acids in the blood. The acid-base disturbances of metabolic alkalosis, respiratory acidosis, and respiratory alkalosis would not correlate with both the low pH and low bicarbonate levels observed here. Metabolic alkalosis would present with a higher pH and elevated bicarbonate. Respiratory acidosis would typically show an elevated pCO2 and is associated with a high HCO3 due to compensatory mechanisms. Respiratory alkalosis, on the other hand, would show an elevated pH with a lowered pCO2

The scenario presented indicates a pH of 7.25, which is below the normal range of 7.35-7.45, suggesting acidosis. Additionally, the bicarbonate (HCO3) level is measured at 14 mEq/L, which is significantly lower than the normal range of 22-28 mEq/L. These values strongly suggest a metabolic acidosis condition.

In metabolic acidosis, the primary disturbance is a decrease in bicarbonate levels, which is evident in this case. The associated symptoms, such as lethargy and fruity breath odor, can indicate the presence of ketones, commonly seen in diabetic ketoacidosis, a condition that leads to metabolic acidosis due to an accumulation of acids in the blood.

The acid-base disturbances of metabolic alkalosis, respiratory acidosis, and respiratory alkalosis would not correlate with both the low pH and low bicarbonate levels observed here. Metabolic alkalosis would present with a higher pH and elevated bicarbonate. Respiratory acidosis would typically show an elevated pCO2 and is associated with a high HCO3 due to compensatory mechanisms. Respiratory alkalosis, on the other hand, would show an elevated pH with a lowered pCO2