A nurse is caring for a client who is experiencing anxiety as well as numbness and tingling of the lips and fingers. The client's ABGS are: pH 7.48 (7.35 to 7.45), PaCO2 30 mm Hg (35 to 45 mm Hg), HCO3 24 mEq/L (21 to 28 mEq/L), PaO2 85 mm Hg (80 to 100 mm Hg). Which of the following acid- base imbalances should the nurse identify that the client is experiencing?

Rationale: A. Respiratory alkalosis: The pH is elevated at 7.48, and the PaCO₂ is decreased at 30 mm Hg, indicating a loss of carbon dioxide due to hyperventilation. The HCO₃ is within normal range, confirming the imbalance is respiratory in origin. This pattern reflects respiratory alkalosis, which is commonly caused by anxiety-induced hyperventilation. B. Respiratory acidosis: Respiratory acidosis is characterized by low pH and elevated PaCO₂. In this case, the pH is high and PaCO₂ is low, which is the opposite pattern of respiratory acidosis. C. Metabolic alkalosis: Metabolic alkalosis involves an elevated pH with an increased HCO₃. While this client’s pH is elevated, their HCO₃ is normal, making a metabolic cause unlikely. D. Metabolic acidosis: Metabolic acidosis presents with a decreased pH and decreased HCO₃. The client’s pH is high and HCO₃ is within the normal range, ruling out this imbalance.