1. A male patient, age 24, is admitted to the ER after an acute barbiturate over

Question

1. A male patient, age 24, is admitted to the ER after an acute barbiturate overdose. Results from an arterial blood gas are as follows. Evaluate the information to determine respiratory or metabolic acidosis or alkalosis, and determine if compensation has occurred (2 points) patient value PH-7.29 HCO3-25meq/L PCO2-70meq/L PO2-70mm/Hg.

Normal Value Arterial Blood gas (ABG's) PH-7.35-7.45, PCO2-35-45mmhg ,PO2-80-100mmhg, HCO3 22-28meg/l

2.Ms. Brown is an elderly woman with diabetes who was too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. On admission her laboratory values show:

patient value

Sodium-156Meq/L

Pottassium-4.0Meq/L

Chloride-115Meq/L

Arterial Blood gases PH-7.30,pco2-40, po2-70,Hco3-20

Normal Vaule.

Sodium-136-146Meq/L

potassium-3.5-5.1Meq/L

chloride 98-106 Meq/L

(ABG's) pH-7.35-7.45

Pco3-35-45mmHg

po2-80-100mmhg

Hco3- -22-28Meq/L

. What type of water and solute imbalance does Ms. Brown have?

b. What symptoms would you expect to find?

c. What do her ABG’s mean?

Explanation / Answer

1)

pH is low – acidotic

PaCO2 is high – acidotic

HCO3 is normal

PaO2 is low – hypoxemia

The primary problem is acidosis (pH) the system that matches pH (acidosis) is the PaCO2 so it’s respiratory. The HCO3 is normal and NOT moving to correct the acidosis so there is NO compensation present. The PaO2 is low and indicate abnormal oxygenation so hypoxemia is present.

Therefore the full interpretation is – Uncompensated respiratory acidosis with hypoxemia

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