LAB ASSIGNMENT €“ FLUID, ELECTROLYTE AND ACID-BASE BALANCE
Assignment Directions

The assignment will cover the following information

1.     Fluid, Electrolyte and Acid-Base Balance

Read the following case and answer the questions that follow

Total points (100) €“ 20 points each

THE CAR ACCIDENT: A CASE STUDY IN ACID-BASE BALANCE

Mr. Henderson, a 52-year-old male, was on his way to work during a heavy rainstorm when he lost control of his car and crossed into oncoming traffic where he collided head-on with a small delivery truck.  Witnesses accessed the 911 emergency medical response system, and paramedics arrived quickly.  The driver of the truck suffered only minor cuts and scrapes, but Mr. Henderson was having difficulty breathing and complaining of severe chest pain.  Transport time to the nearest trauma center was less than two minutes, so the emergency personnel elected to scoop and haul.  A large bruise on his chest indicated that Mr. Henderson had experienced blunt trauma from the impact of the steering wheel after the airbag failed to deploy.
Mr. Henderson presented in the ER with blurred vision, dizziness, headache, nausea, muscle weakness, hypoventilation, and a feeling of mental confusion.  A chest X ray revealed bilateral fractures in the fourth, fifth, and six ribs along with a suspected hemothorax.  An ECG revealed signs of ventricular arrhythmias.  The values following values were taken from the results of an arterial blood gas (ABG) and urinalysis (UA).

Arterial Blood Gas (ABG)    High or Low
pH:        7.0             Low
Pco2:        62                 High
bicarbonate:    29 mEq/L          High

Urinalysis (UA)
pH:        4.0             Low

Answer the following:

1.    Define the following terms and tell how they relate to this case.
a.    Bilateral
b.    Hypoventilation
c.    Hemothorax
d.    Arrhythmias

2.    Mr. Henderson fractured fourth, fifth, and six ribs.

a.    What organ system is located under these ribs that relate to this case?

b.    How does a hemothorax relate to the fractured ribs?  What diagnostic tool would be used to confirm a hemothorax?
c.    In this case, would you expect Mr. Henderson’s PCO2 levels to increase?  Why?
d.    What other condition listed in this case would also cause an increase in PCO2?
e.    What treatment option would be used to resolve the heomthorax?

3.    The values listed in the case were taken from the results of an arterial blood gas (ABG) and urinalysis (UA).  What are the normal ranges from the measurements listed are the blood and urine tests?

4.    Mr. Henderson’s PCO2 is high but his pH is low.
a.    Is this expected?
b.    What is causing his pH to drop?

5.    Will the treatment option you listed   (#2-d) also resolve the problem with the drop in pH?  Please explain.