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Question: John is a 59-year-old man admitted to the emergency department with complaints of severe shortnes…

John is a 59-year-old man admitted to the emergency department with complaints of severe shortness of breath and a cough producing frothy, blood-tinged mucous. His history reveals a myocardial infarction 2 years ago. Since then, he has been on a low-salt diet, digoxin, and furosemide for control of congestive heart failure.

The client is admitted to the hospital for treatment of acute pulmonary edema secondary to congestive heart failure. On his fourth hospital day, the client complains of tingling and numbness of his fingers, muscle weakness, and palpitations. His electrocardiogram shows frequent premature ventricular contractions (PVCs). Four hours later, he is confused and restless.

The client’s diagnostic findings are as follows:

Arterial Blood Gases: pH 7.55, PaCO2 25 mm Hg, HCO3 34 mEq/L, PaO2 65 mm Hg, SaO2 91%

Hematology: K = 2.5 mEq/L

1. What are the most likely causes of the acid-base imbalance?

A. Review the concepts of acid-base balance and imbalance, respiratory compensation, and metabolic compensation. On the basis of the data provided, interpret the client’s blood gases.

B. Investigate common factors that contribute to the development of acid-base imbalance and compare those factors with the client’s data.

C. Identify the most likely cause of the client’s acid-base imbalance.