Acidosis/Alkalosis; Respiratory/Metabolic

[pcp_9588]

1. Sandy, a 16-year-old woman, returns to the emergency room for the fifth time. She has been treated for Bulimia repeatedly. On initial assessment, you note shallow breathing.
ARTERIAL BLOOD GASES are as follows:
pH = 7.45
PaCO2 =47 mmHg
HCO3- = 33 mEq/Liter
My answer is Complete Compensated Respiratory Acidosis but I'm a little iffy about it because bulimia can be prolonged vomiting which can cause metabolic alkalosis, while the shallow breathing can cause respiratory acidosis.

2. Mitch, age 36 is admitted to the ER for an acute onset of an asthma attack. The asthma attach has lasted at least one hour before blood gases are drawn.
ARTERIAL BLOOD GASES are as follows:
pH = 7.10
PaCO2 = 80 mmHg
HCO3- = 25 mEq/Liter
My Answer: Uncompensated Respiratory Acidosis

3. Cassandra has Type I diabetes. She had the flu for the last 3 days and has lost her appetite. In addition, she has neglected to administer her insulin shots. Upon admission, you note that her breathing is heavy and her breath is fruity in odor
ARTERIAL BLOOD GASES are as follows:
pH = 7.30
PaCO2 = 23 mmHg
HCO3- = 9 mEq/Liter
My answer: Partially Compensated Metabolic Acidosis

4. Chad has been admitted to the ER for passing out during an A & P Exam. Prior to the exam his classmates
noticed that he was hyperventilating and expressed nervousness because he had not studied.
ARTERIAL BLOOD GASES are as follows:
pH = 7.50
PaCO2 = 29 mmHg
HCO3- = 24 mEq/Liter
My answer: Uncompensated Respiratory Alkalosis

 

Please double check if my answers are correct thanks!

[Prometheus]

Been a while since i've looked at an ABG so might be a bit rusty, but since no-one else is biting i'll have a look.

 

1.) Yeah, a bit iffy. I would go with metabolic alkalosis with respiratory compensation as the pH is 7.45. The important thing (in real life at least) is to know what information you need to decide between the possibilities. For instance time from onset of symptoms could help in determining which it is as metabolic compensation takes longer the respiratory compensation. The are also clinical tests which could help determine which.

 

2.) Agree. It is weird though that the CO2 has risen so quickly. Think there is something else going on here, not a typical asthma picture. Sick boy.

 

3.) Agree.

 

4.) Agree.

 

Hope that helps a bit. What are you studying?