Situation: Benedict Santos, A 59-year-old man, presents with three days of dyspnea, fever, chest pain, and a productive cough with bloody sputum. The medical assistant in the emergency room finds the saturation of at 86% value. The medic decided to get the arterial blood gas (ABG) of the room as they wait for a radiographer to do a chest X-ray on him.
Background: One week ago, a 59-year-old man was diagnosed with pulmonary thrombosis. He has a history of thyroid gland surgery, used salicylates to reduce the pain for a long. He has smoked cigarettes for the past 15 years. Doctors have advised him to quit smoking, and he claims he uses electronic cigarettes currently.
Assessment: BP 136/89 (MAP 106) VS: HR 75 RR 5 spontaneous on a ventilator. Temp 98.2. Cardiac: WNL Neuro: lethargic Axillary. Pain: S&S pain noted Symmetry: even Resp: Lung sounds- moderately coarse. ETT- size 8 O2 sat 94%. Labs: Chem panel WNL CBC WNL. ABG: PaCO2 25 pH 7.50 PO2 65 HCO3 24. Chest x-ray- indication: moderate white patches present in the lung bases.
Recommendations: Keenly take note of the signs of neuromuscular, neurologic, and cardiovascular functioning. Monitor ABGS and vital signs
Q.1- A person in a coma had his arterial blood gas showing the following values: HCO3 – 5 mmol/l PCO2 16 mm Hg, and pH 7.1. What was the acid-base disorder?
- a) Metabolic Alkalosis
- b) Metabolic Acidosis
- c) Respiratory Alkalosis
- d) Respiratory Acidosis
Q.2- It was prudent to aspirate a man’s contents in the upper part of the gastrointestinal tract while undergoing surgery. Later, the following arterial blood sample values were obtained, PCO2 52 pH 7.55mm Hg and HCO3 – 40 mmol/l. Mention the disorder that ensued.
- a) Metabolic Alkalosis
- b) Metabolic Acidosis
- c) Respiratory Alkalosis
- d) Respiratory Acidosis
Q.3- A woman is nervous on her wedding day and breathes rapidly. What would be the outcome?
- Respiratory Acidosis
- Respiratory Alkalosis
- Metabolic Acidosis
- Metabolic Alkalosis
Answers and Rationale
- The normal ranges for PaCO2 is often 38 to 42mmHG, Ph. of Arterial blood 7.38. Sao2 between 94- 100% and Bicarbonate 22-28mEq/L (Zaher, Asim, Jaya, Desiree, Kelsey Nicholas, Kirk, William, & Andrew, 2019).
- The patient’s Ph value was above the normal range, which is often between 7.38 to 7.42. Consequently, the arterial blood became alkaline (Zaher, Asim, Jaya, Desiree, Kelsey Nicholas, Kirk, William, & Andrew, 2019).
- The alkalosis happens when one breath was rapidly causing the CO2 level to reduce drastically; thus, the blood PH rises.
References
Zaher, F., Asim, A., Jaya, D., Desiree, T., Kelsey, D., Nicholas, G., Kirk, N., William, S., & Andrew J. (2019). Inadequacy of pulse oximetry in the catheterization laboratory: An exploratory study monitoring respiratory status using Arterial Blood Gases during cardiac catheterization with conscious sedation, 20 (6), 461-467