— 生理適應 · HARD · MCQ —
下列哪項動脈血氣分析 (ABG) 結果代表「部分代償」的代謝性酸中毒？
Which of the following ABG results indicates partially compensated metabolic acidosis?
- ApH 7.32, PaCO2 45 mmHg, HCO3 20 mEq/LpH 7.32、PaCO2 45 mmHg、HCO3 20 mEq/L
- BpH 7.25, PaCO2 50 mmHg, HCO3 26 mEq/LpH 7.25、PaCO2 50 mmHg、HCO3 26 mEq/L
- CpH 7.30, PaCO2 30 mmHg, HCO3 18 mEq/L✓ 正解pH 7.30、PaCO2 30 mmHg、HCO3 18 mEq/L
- DpH 7.42, PaCO2 32 mmHg, HCO3 19 mEq/LpH 7.42、PaCO2 32 mmHg、HCO3 19 mEq/L
— Explanation · 中文詳解 —
部分代償的代謝性酸中毒特徵：(1) pH 異常（酸性 <7.35）；(2) HCO3 異常（原發性降低 <22）；(3) PaCO2 異常（代償性降低 <35）試圖拉高 pH，但 pH 尚未回到正常範圍。A 符合。B 為未代償；C 為完全代償（pH 正常）；D 為呼吸性酸中毒。
Characteristics of partially compensated metabolic acidosis: (1) abnormal pH (acidic, <7.35); (2) abnormal HCO3 (primary decrease, <22); (3) abnormal PaCO2 (compensatory decrease, <35) attempting to raise the pH, but the pH has not yet returned to the normal range. A meets these criteria. A is uncompensated; D is fully compensated (pH normal); B is respiratory acidosis.
✦ 台美臨床差異
NCLEX 考題常將 ABG 判讀與臨床情境結合；台灣護理國考則較偏重純數據判讀。