Acid Base Imbalances Scenario Analysis

Description

Scenario

A 75-year-old man was admitted with shortness of breath and lower extremity edema. He has been unwell for about a week and had multiple bouts of diarrhea over the previous 5 days. He does not take any medications. He was hyperventilating and was very distressed when EMS arrived. Admission arterial blood gas is listed below. He was on high concentration oxygen by mask on arrival to the emergency department.

Chemistry Results

Na+ = 127
HCO3- 20
HCO- = 30meq/L 3
K+ = 5.2
BUN 50.5
Glucose 9.5 mmols/l
Cl- 79
Creatinine 0.38
Anion gap 33 mmols/l

Arterial Blood Gases

pH 7.58
pCO2 21 mmHg
pO2 154 mmHg
HCO3 19 mmol/l

Questions

Answer the Following Questions:

What is this patients acid-base disorder?
Discuss why you how you came to that conclusion.
Is the patient compensating?
What are the pathophysiological responses that the body is attempting to use to compensate?

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