1. Define noncompliant. 2. Is this person experiencing ketoacidosis or insulin shock? Explain your answer. 3. Why is the serum bicarbonate low?
op of Form
Normal Levels of Substances in the Arterial Blood:
|
pH |
7.40 + 0.05 |
|
pCO2 (partial pressure of carbon dioxide) |
40 mm Hg |
|
pO2 (partial pressure of oxygen) |
90 - 100 mm Hg |
|
Hemoglobin - O2 saturation |
94 - 100 % |
|
[HCO3-] |
24 meq / liter |
Vignette #1:
A 21-year-old noncompliant female with a history of type I (insulin-dependent) diabetes mellitus was found in a coma. Her blood glucose was high, as well as her urine glucose, urine
1. Define noncompliant.
2. Is this person experiencing ketoacidosis or insulin shock? Explain your answer.
3. Why is the serum bicarbonate low?
4. What is the acid-base status of this individual?
5. What are the causes of the dyspnea, hypotension, and tachycardia?
6. What type of treatment does this person need?
Vignette #2:
A 28-year-old woman has been sick with the flu for the past week, vomiting several times every day. She is having a difficult time keeping solids and liquids down, and has become severely dehydrated. After fainting at work, she was taken to a walk-in clinic, where an IV was placed to help rehydrate her. Arterial blood was drawn first, revealing the following:
|
pH |
7.50 |
|
pCO2 |
40 mm Hg |
|
pO2 |
95 mm Hg |
|
Hemoglobin - O2 saturation |
97% |
|
[HCO3-] |
32 meq / liter |
Questions:
1. How would you classify her acid-base disturbance?
2. Why might excessive vomiting cause her particular acid-base disturbance?
3. How do the kidneys respond to this acid-base disturbance?
4. What is the respiratory response?
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