Certified Pediatric Nurse (CPN)

What acid-base imbalance is indicated by the following ABG results: pH = 7.32, CO2 = 48, HCO3 = 23?

1. Metabolic acidosis

2. Respiratory alkalosis

3. Respiratory acidosis

4. Metabolic alkalosis

The correct answer is: Respiratory acidosis

The indicated acid-base imbalance is respiratory acidosis, which is characterized by a primary increase in carbon dioxide (CO2) levels in the blood, leading to a decrease in pH. In the provided ABG results, the pH is 7.32, which falls below the normal range of 7.35 to 7.45, indicating acidosis. The CO2 level is 48, which is elevated and suggests that the primary issue is an accumulation of CO2 due to hypoventilation or inadequate gas exchange, common in respiratory conditions. The bicarbonate (HCO3) level is 23, which is within the normal range (22-26), suggesting that the kidneys have not yet compensated significantly for the respiratory acidosis. In respiratory acidosis, the initial insult typically comes from respiratory failure, while the bicarbonate levels may adjust over time to compensate for the increased acidity. Understanding this, respiratory alkalosis involves a low CO2 with a high pH, while metabolic acidosis would typically show low pH with low bicarbonate rather than just the elevation in CO2. Since the data aligns with the characteristics of respiratory acidosis, that is the correct identification of the acid-base imbalance.