Acid-Base Case Study
Mr. Davis is 56-year-old male who has a past medical history of HTN (hypertension). Every Sunday, he goes to his favorite restaurant to watch sports with his friends. While making several trips to the restroom over in 1 hour, Mr. Davis complains of feeling tired and weak. He starts sweating profusely, his breathing becomes rapid and deep, his speech is slurred, and eventually he passes out. His friends call 911, and Mr. Davis is transported to the hospital. On admission to the hospital, Mr. Davis’s lab work shows the following values:
| Mr. Davis’s Values | Normal Ranges | |
| Sodium (Na+) | 155.0 mEq/L | |
| Potassium (K+) | 6.2 mEq/L | |
| Chloride (Cl-) | 120.0 mEq/L | |
| Glucose | 52.0 mg/dL | |
| ABG
pH pCO2 HCO3 |
7.15
30 16 |
|
| UA
Ketones Protein |
+
+ |
- 1. Research and fill in the normal values for the table. Include the table in your essay.
- 2. What type of acid-base disturbance is Mr. Davis suffering from and why?
- 3. What role does excessive alcohol consumption play in the acid-base disturbance seen?
- 4. What type of fluid or electrolyte imbalances does Mr. Davis have and why?
- 5. Calculate the anion gap. Is it high or normal? Why is it high or normal? What information does the anion gap give the provider?
- 6. Are Mr. Davis’ respiratory and renal systems attempting to compensate for his acid-base disturbance? If so, how are they compensating and what evidence do you have that they are compensating?
- 7. Explain the rationale for the low glucose level and high urine ketones.
- 8. Is the protein level seen in the UA abnormal? Provide a rationale. How do the findings relate to Mr. Davis?
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