c. A critical care unit nurse presents to the ED with severe dizziness. She appe

Question

c. A critical care unit nurse presents to the ED with severe dizziness. She appears to be a fit woman. She was not forth coming for any other history. Her ABG and blood panel are below. Her blood work reveals hyponatremia, hypokalemia and a very high bicarbonate (which can only be due to severe metabolic alkalosis or metabolic compensation for severe respiratory acidosis (more common). Na+ 12:3 K+ 3.1 C-67 ????--42 Slu 125 pH 7.55 Paco2- 50 HCO343 BUN 25 i. Determine her acid/base balance based on the above numbers. (4 pts) ii. Confirm her measured bicarbonate level. Then remember that her Paco2 should go up by 0.6 for each mEa/L her bicarbonate value is over 24. Go ahead and do that math. (2 pts -show your work)

Explanation / Answer

1) In normal ABG condition both HCO3 and PaCO2 moves in same direction

so % diffrence of HCO3 calculated as = 42-28/28 =0.5

so % diffrence of PaCO2 calculated as = 50-40/40=0.33

overall here dominant alkalosis is the case and acid base balance shift towards basicity as HCO3 ions incresed 2 times from the nornal level.

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