Case of the Week: Acid-Base Disturbance #4

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Go to the profile of Julie Grishaw, ACNP
May 01, 2018
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Clinical Scenario

A 70-year-old male with severe COPD presents to the emergency department, obtunded, with rapid shallow breathing. He is intubated in the emergency department. His wife reports that he has been experiencing worsening shortness of breath at home, with increased sputum production and some low-grade fevers. He is normotensive on admission to the intensive care unit.

 

Laboratory Data:

ABG

Basic Metabolic Panel

pH

7.07

Na

140 mEq/L

PaCO2

107 mm Hg

K

4.1 mEq/L

PaO2

55 mm Hg

Cl

93 mEq/L

HCO3

44 mEq/L

CO2

45 mEq/L

FIO2

0.36

BUN

15 mg/dL

Cr

1.1 mg/dL



Question 1 of 6:

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 acidosis

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https://accessmedicine.mhmedical.com/CaseContent.aspx?gbosID=396034&gbosContainerID=181&viewByNumber=false#178509603

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Go to the profile of Julie Grishaw, ACNP

Julie Grishaw, ACNP

Senior Editor, McGraw-Hill Education

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