Question

15. Mr. Appel has severe chronic obstructive pulmonary disease (COPD). He is admitted to the hospital with the complaint of increasing dyspnea, increased sputum, anxiety, and diaphoresis. He states he feels weak and tired. He routinely takes a diuretic (furosemide) and his pulmonary medications. Patient values: Sodium (Na+) 140 mEq/L Potassium (K+) 2.0 mEq/L Chloride (Cl–) 105 mEq/L Arterial blood gases (ABGs): pH - 7.25; PCO2 - 78 mm Hg; PO2 - 60 mm Hg; HCO3 - 30 mEq/L Normal values: Sodium (Na+) 136-146 mEq/L Potassium (K+) 3.5-5.1 mEq/L Chloride (Cl–) 98-106 mEq/L Arterial blood gases (ABGs): pH 7.35-7.45 PCO2 45-35 mm Hg PO2 80-100 mm Hg HCO3- 22-26 mEq/L a. What type of imbalance does Mr. Appel have? (2 point) b. Interpret his ABG’s.

Answer 1

15. a. What type of imbalance does Mr. Appel have?

Mr.Appeal has hypokalemia (low potassium level) as a result of diuresis. Diaphoresis further decreases potassium levels. The sodium, chloride, are within normal limits. He has low pH, increased PCo2 and bicarbonate ions. It indicates an acid-base imbalance of Respiratory acidosis.

b. Interpret his ABG’s.

Mr. Appeal has a low pH which resembles acidosis. The normal range of pH value is 7.35 to 7.45. Low level of the partial pressure of Oxygenation indicates decreased ventilation which increases the carbon dioxide level in the blood. This, in turn, increases bicarbonate levels which clearly states Mr.Appel has Respiratory acidosis. His condition of COPD exacerbates the hypoventilation and hypercapnia due to improper respiration.