Case o f the Week: Acid-Base Disturbance #1

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Go to the profile of Julie Grishaw, ACNP
Apr 10, 2018
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A 44-year-old homeless person with schizophrenia and alcoholism presents to the emergency department with altered mental status and renal failure. He is intubated shortly after arrival due to an inability to protect his airway. There is no additional history available. He is tachypneic with a respiratory rate in the 30s prior to intubation.

Laboratory Data:

ABG

Basic Metabolic Panel

pH

7.06

Na

131 mEq/L

PaCO2

30 mm Hg

K

5.6 mEq/L

PaO2

80 mm Hg

Cl

98 mEq/L

HCO3

7 mEq/L

CO2

7 mEq/L

BUN

68 mg/dL

Cr

3.8 mg/dL

Albumin

2.0 g/dL

 

What is/are the primary acid-base disturbance(s) occurring in this case?

A – Metabolic acidosis only

B – Respiratory acidosis only

C – Metabolic acidosis and a respiratory acidosis

D – Metabolic alkalosis and a respiratory alkalosis


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Go to the profile of Julie Grishaw, ACNP

Julie Grishaw, ACNP

Senior Editor, McGraw-Hill Education

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