AccessMedicine Channel, AccessMedicine's Case of the Week

AccessMedicine's Case of the Week: Acid-Base Disturbances Case #31

From: AccessMedicine

Oct 05, 2020

Julie Grishaw, ACNP

Senior Editor, McGraw-Hill Education

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Case:

An 18-year-old man with a past medical history of major depression is found comatose at home. He was last seen normal 2 days prior. He is noted to be hypotensive and tachycardic, and his skin is cool and clammy. Before intubation, an ABG is obtained, the results of which are listed below. He is oliguric, with scant red-tinged urine in his catheter bag.

Laboratory Data:
ABG		Basic Metabolic Panel
pH	7.25	NA	135 mEq/L
PaCO₂	23 mm Hg	K	5.2 mEq/L
PaO₂	77 mm Hg	Cl	102 mEq/L
HCO₃	10 mEq/L	CO₂	10 mEq/L
		BUN	50 mg/dL
		Cr	3.1 mg/dL

Question 1 of 3:

What is the primary acid-base disorder in this patient?

A - Metabolic acidosis

B - Metabolic alkalosis

C - Respiratory acidosis

D - Respiratory alkalosis

Click HERE to answer the questions and complete the case!

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Julie Grishaw, ACNP

Senior Editor, McGraw-Hill Education

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