Case Vignettes in Acid-Base Balance Essay Example for Free

Case sketchs in Acid-Base Balance EssayChoose three of the four vignettes and concisely answer the questions that follow. Normal Levels of Substances in the Arterial BloodpH 7.40 + 0.05pCO2 (partial pressure of carbon dioxide) 40 mm HgpO2 (partial pressure of oxygen) 90 100 mm HgHemoglobin O2 saturation 94 100 %HCO3- 24 meq / literVignette 1A 14-year-old girl with cystic fibrosis has complained of an increased expecto straddle productive of green sputum over the last week. She also complained of being increasingly short of breath, and she is noticeably wheezing on physical examination. Arterial daub was drawn and sampled, revealing the future(a) valuespH 7.30pCO2 50 mm HgpO2 55 mm HgHemoglobin O2saturation45 %HCO3- 24 meq / literQuestions1. How would you classify this girls acid-base experimental condition?2. How does cystic fibrosis cause this acid-base imbalance?3. How would the kidneys try to breed for the girls acid-base imbalance? 4. List some other causes of thi s type of acid-base disturbance. Vignette 2A 76-year-old man complained to his wife of severe sub-sternal chest pains that radiated down the inside of his left arm.Shortly afterward, he collapsed on the living live floor. Paramedics arriving at his house just minutes later found him unresponsive, not breathing, and without a pulse. CPR and electroconvulsive shock were required to start his heart beatingagain. Upon arriver at the Emergency Room, the man started to regain consciousness, complaining of severe shortness of breath (dyspnea) and continued chest pain. On physical examination, his vital signs were as follows general blood 85 mm Hg / 50 mm pressure HgHeart rate 175 beats / minuteRespiratory rate 32 breaths / minuteTemperature 99.2oFHis breathing was labored, his pulses were rapid and weak everywhere, and his skin was cold and clammy. An ECG was done, revealing significant Q waves in most of the leads. Blood exam revealed markedly elevated creatine phosphokinase (CPK) lev els of cardiac muscle origin. Arterial blood was sampled and revealed the following pH 7.22pCO2 30 mm HgpO2 70 mm HgHemoglobin O2 saturation 88 %HCO3- 2 meq / literQuestions5. What is the diagnosis? What evidence supports your diagnosis? 6. How would you classify his acid-base status? What specifically caused this acidbase disturbance? 7. How has his body started to compensate for this acid-base disturbance? 8. List some other causes of this type of acid-base disturbance. Vignette 3An elderly gentleman is in a coma after suffering a severe stroke. He is in the intensive care unit and has been placed on a ventilator. Arterial blood gas measurements from the patient reveal the followingpH 7.50pCO2 30 mm HgpO2 100 mm HgHemoglobin O2 saturation 98%HCO3- 24 meq / literQuestions9. How would you classify this patients acid-base status?10. How does this patients hyperventilation pattern raise the pH of the blood? 11. How might the kidneys respond to this acid-base disturbance? 12. List so me other causes of this type of acid-base disturbance.