Question

Ms. X is a 30-year old African American female who presented to the ED with a complaint of body aches. She reports generalized body aches and joint pains. The pain is constant, throbbing in nature and is a 10 out of 10 in severity. The pain has been ongoing for the last week and has progressively gotten worse. She was seen in the ED 5 days ago, given pain medication and discharged. She has had profuse diarrhea and fevers for the last 3 days. She denies any dyspnea, cough, abdominal pain, nausea, or vomiting. Her past medical history is significant for sickle cell anemia, iron overload. CVA 16 years ago, splenic infarction, and acute chest syndrome. Vitals 99.4 – 117 – 24 – 136/87, O2 sat is 100% on Room air. She is oriented x3. Restless. Heart rate is regular, no murmur or gallop. Lungs are clear bilaterally. Abdomen soft and nontender. No peritoneal signs. Elbows, shoulders, and knees are tender to touch bilaterally.

1. The clinical scenario is most consistent with which acid base disorder and what data in the clinical scenario supports your diagnosis?

Answer 1

She has metabolic acidosis due severe diarrhea from past three days.during diarrhea a large amount of bicarbonate may be lost in the stool.Then base deficit and acidosis occurs rapidly.some times patient Can go to hypovolaemic shock due to the severity of passing loose stool.this results the excessive production of lactic acid which can lead to metabolic acidosis.