Question

Scenario #4: Mrs. D. is a 45 year old female admitted with a history of diabetes. She has a temperature of 101.8, P 110, RR- 30, B/P-90/70. Labs are drawn and reveal a glucose of 780 mg positive ketones, and the following ABGs: pH 7.25 PaCO2 30 mm Hg HCO3- 22 mEq/L What is the acid base disturbance? A. Respiratory Acidosis B. Respiratory Alkalosis 13. C. Metabolic Acidosis D. Metabolic Alkalosis Is the acid base disturbance compensated or uncompensated? A. No compensation 14. B. Partial compensation C. Full compensation What are some causes of this disorder? A. vomiting, diarrhea, prolonged diuretics B. pain, fever, hyperventilation C. pneumonia, hypoventilation, pneumothorax D. renal failure, ASA overdose, starvation, ketoacidosis 15. What are some of the interventions for this disorder? A. IV fluids & Insulin, NAHCO3 based on ABGs only B. vigorous pulmonary toilet, antibiotics, diuretics, mechanical ventilation C. sedatives or analgesics, breathe into paper bag, mechanical vent to decrease rate D. K+ replacement, IV fluids, antidiarrheal or antiemetic 16.

Answer 1

ANSWER

13.C. This patient lab report shows,

             * Low pH = 7.25 (Normal 7.35 -7.45)

             * Presence of ketone bodies which are acidic.

             * Glucose 780 mg/dL.

      * So it indicate diabetic ketoacidosis which is a type of

          Metabolic acidosis.

14.B. ABG result of this patient shows,

           pH = 7.25 (Normal 7.35 - 7.45)

           PaCO2 = 30 mm Hg. (Normal ; 35 -45 mm Hg).

           HCO3 = 22 mEq/L.

   * When the patient has a metabolic acidosis body will compensate it by

      decreasing the amount of PaCO2(Acidic)in the patient body system.

   * But here compensation of PaCO2 (30 mm Hg) not enough to bring the

     pH (7.25) back to normal level so it is a Partial compensation.

15.D. Causes of metabolic acidosis include,

             * Renal failure.

             * ASA overdose.

         * Starvation.

         * Ketoacidosis.

16.A.Interventions for metabolic acidosis.

            * IV fluids and insulin.

            * NAHCO3 based on ABGs only.