Skip to Main Content

++

Chapter 28. Acid–Base Disturbances

++
++
++

A 70-year-old woman with multiple recent admissions for congestive heart failure and medical noncompliance presents to the ED with progressive dyspnea and bilateral leg swelling. She is in significant respiratory distress with markedly labored respirations. Laboratory data immediately before intubation are as follows: pH 7.24, Paco2 60 mm Hg (8.0 kPa), HCO3- 26 mEq/L (26 mmol/L).

+

The clinical scenario and laboratory findings suggest which of the following?

++
++
++

A. Pulmonary edema with acute respiratory acidosis

++
++

B. Exacerbation of chronic obstructive pulmonary disease with chronic respiratory acidosis

++
++

C. Excessive diuresis with chronic metabolic alkalosis

++
++

D. New-onset diabetic ketoacidosis

++
++
++

A 70-year-old woman with multiple recent admissions for congestive heart failure and medical noncompliance presents to the ED with progressive dyspnea and bilateral leg swelling. She is in significant respiratory distress with markedly labored respirations. Laboratory data immediately before intubation are as follows: pH 7.24, Paco2 60 mm Hg (8.0 kPa), HCO3- 26 mEq/L (26 mmol/L).

+

Is the observed compensation appropriate?

++
++
++

A. No, the HCO3- has increased by 2 mEq/L (2 mmol/L)

++
++

B. Yes, the HCO3- has increased by 2 mEq/L (2 mmol/L)

++
++

C. Yes, the Paco2 has increased by 20 mm Hg (2.7 kPa)

++
++

D. No, the Paco2 has increased by 20 mm Hg (2.7 kPa)

++
++
++

A 70-year-old woman with multiple recent admissions for congestive heart failure and medical noncompliance presents to the ED with progressive dyspnea and bilateral leg swelling. She is in significant respiratory distress with markedly labored respirations. Laboratory data immediately before intubation are as follows: pH 7.24, Paco2 60 mm Hg (8.0 kPa), HCO3- 26 mEq/L (26 mmol/L).

+

This patient had a difficult airway and during efforts to establish an artificial airway the Paco2 increased by an additional 10 mm Hg (1.3 kPa). What would you expect the pH to be?

++
++
++

A. 7.32

++
++

B. 7.24

++
++

C. 7.16

++
++

D. 7.14

++
++
++

A 20-year-old insulin-dependent diabetic is admitted for excessive thirst and polyuria. She has not taken her insulin therapy for “several days” because she could not afford her medications. Her laboratory test results reveal pH 7.26, Paco2 16 mm Hg (2.1 kPa), HCO3- 10 mEq/L (10 mmol/L), sodium 136 mEq/L (136 ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.