A client with a history of severe diarrhea presents to the emergency department. Vital signs reveal a respiratory rate of 36 breaths per minute, heart rate 110 bpm, and blood pressure 90/60 mm Hg. Arterial blood gas results include: pH 7.30, PaCO2 29 mm Hg, PaO2 100 mm Hg, and HCO3- 21 mEq/L. How does the nurse interpret these findings?

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Metabolic acidosis. Normal arterial blood gas results include, pH 7.35 to 7.45, PaCO2 35 to 45 mm Hg, PaO2 75 to 100 mm Hg, HCO&sup3;- 22 to 28 mEq/L, and oxygen saturation 94 to 100%. Metabolic acidosis is present when pH is less than 7.35 and PaCO2 and HCO3- are below normal and can occur following severe diarrhea. Metabolic alkalosis is present when pH is greater than 7.45, and PaCO2 and HCO3- are higher than normal. Respiratory acidosis occurs when pH is less than 7.35 and PaCO2 and HCO3- are higher than normal. Respiratory alkalosis is present when pH is greater than 7.45 and PaCO2 and HCO3- are lower than normal. The severe diarrhea probably lead to a loss of bicarbonate.

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