AccessMedicine's Case of the Week: Acid-Base Disturbance Case 36

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Go to the profile of Julie Grishaw, ACNP
Jan 03, 2020
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Case

A 55-year-old male is transferred to the ICU from the PACU following surgery for a benign skin tumor. He required general anesthesia due to comorbid medical conditions. The procedure required only 20 minutes, and the patient returned to the PACU, where he was noted to develop hypertension, tachypnea, and muscle rigidity. He was transferred emergently to the ICU for further management. Blood pressure is 190/110 mm Hg, and heart rate is 145 bpm. Temperature 105.5°F. 

Laboratory Data:

ABG

Basic Metabolic Panel

pH

6.92

Na

139 mEq/L

PaCO2

50 mm Hg

K

6.5 mEq/L

PaO2

100 mm Hg

Cl

99 mEq/L

HCO3

10 mEq/L

CO2

10 mEq/L

BUN

44 mg/dL

Cr

1.9 mg/dL

Glucose

67 mg/dL

Albumin

4 g/dL

EtOH

0 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 alkalosis

E - Metabolic alkalosis

F - 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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