A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

A. pH 7.30, HCO3- 26 mEq/L, PaCO2 50 mm Hg: The pH of 7.30 indicates acidosis. Bicarbonate (HCO3-) is normal (26 mEq/L), so metabolic acidosis is unlikely. PaCO2 is elevated (50 mm Hg), indicating respiratory acidosis. Respiratory acidosis is not typical in chronic kidney disease, which usually causes metabolic acidosis due to impaired acid excretion. B. pH 7.55, HCO3- 30 mEq/L, PaCO2 31 mm Hg: The pH of 7.55 indicates alkalosis. Bicarbonate is elevated (30 mEq/L), which suggests metabolic alkalosis. PaCO2 is low (31 mm Hg), a possible respiratory compensation for metabolic alkalosis. This acid-base status is inconsistent with CKD, where acidosis is expected, not alkalosis. C. pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg: The pH of 7.25 indicates acidosis. Bicarbonate is low (19 mEq/L), indicating metabolic acidosis. PaCO2 is low (30 mm Hg), showing respiratory compensation via hyperventilation. This is the classic ABG pattern in chronic kidney disease due to retention of acids and loss of bicarbonate. D. pH 7.50, HCO3- 20 mEq/L, PaCO2 32 mm Hg: The pH of 7.50 indicates alkalosis. Bicarbonate is low (20 mEq/L), which does not match metabolic alkalosis (bicarb should be high). PaCO2 is low (32 mm Hg), consistent with respiratory alkalosis. This combination is inconsistent and not typical for CKD, which primarily causes metabolic acidosis.