— 生理適應 · MEDIUM · MCQ —
一位病人因急性呼吸衰竭入院，護理師預期會看到哪種動脈血液氣體分析（ABG）結果？
A client is admitted with acute respiratory failure. Which arterial blood gas (ABG) result would the nurse expect?
- ApH 7.35, HCO3 22 mEq/LpH 7.35、HCO3 22 mEq/L
- BpH 7.30, PaCO2 55 mmHg✓ 正解pH 7.30、PaCO2 55 mmHg
- CpH 7.45, PaCO2 40 mmHgpH 7.45、PaCO2 40 mmHg
- DpH 7.50, PaCO2 30 mmHgpH 7.50、PaCO2 30 mmHg
— Explanation · 中文詳解 —
急性呼吸衰竭的核心病理生理為換氣不足（hypoventilation），導致二氧化碳（CO2）滯留於體內。由於 CO2 與水結合形成碳酸，血中 CO2 分壓升高會導致 pH 值下降，形成呼吸性酸中毒。正確答案 B 符合呼吸性酸中毒的特徵：pH < 7.35 且 PaCO2 > 45 mmHg。臨床上，護理師需優先評估病人的氧合與通氣狀況，並準備進行氣道支持。
The core pathophysiology of acute respiratory failure is hypoventilation, which causes carbon dioxide (CO2) retention. Because CO2 combines with water to form carbonic acid, elevated PaCO2 lowers the pH and produces respiratory acidosis. The correct answer, B, meets the criteria for respiratory acidosis: pH < 7.35 and PaCO2 > 45 mmHg. Clinically, the nurse should prioritize assessment of oxygenation and ventilation and prepare for airway support.