— 生理適應 · EASY · MCQ —
一位病患因嚴重嘔吐被診斷為代謝性鹼中毒。護理師應預期哪種動脈血氣（ABG）數據？
A client is diagnosed with metabolic alkalosis following excessive vomiting. Which arterial blood gas (ABG) findings should the nurse expect?
- ApH 7.32, HCO3- 18 mEq/LpH 7.32、HCO3- 18 mEq/L
- BpH 7.48, HCO3- 32 mEq/L✓ 正解pH 7.48、HCO3- 32 mEq/L
- CpH 7.30, PaCO2 50 mmHgpH 7.30、PaCO2 50 mmHg
- DpH 7.45, PaCO2 40 mmHgpH 7.45、PaCO2 40 mmHg
— Explanation · 中文詳解 —
代謝性鹼中毒（Metabolic alkalosis）的特徵是 pH 值上升（>7.45）及碳酸氫根（HCO3-）增加（>26 mEq/L）。嚴重嘔吐導致胃酸（鹽酸）流失，體內氫離子濃度下降，導致鹼性物質相對過剩。此時身體為了代償，會抑制呼吸以保留二氧化碳（酸性物質），因此 PaCO2 可能會升高。
Metabolic alkalosis is characterized by elevated pH (>7.45) and increased bicarbonate (HCO3-, >26 mEq/L). Severe vomiting causes loss of gastric acid (hydrochloric acid) and decreases the body's hydrogen ion concentration, leading to a relative excess of alkaline substances. To compensate, the body suppresses respiration to retain carbon dioxide (an acidic substance), so PaCO2 may rise.