Case Vignettes in Acid-Base Balance Essay Example for Free

Case Vignettes in Acid-Base Balance EssayChoose three of the quaternary vignettes and BRIEFLY answer the questions that follow. Normal Levels of Substances in the Arterial gillyflowerpH 7.40 + 0.05pCO2 (partial pressure of carbon dioxide) 40 mm HgpO2 (partial pressure of oxygen) 90 100 mm HgHemoglobin O2 strength 94 100 %HCO3- 24 meq / literVignette 1A 14-year-old girl with cystic fibrosis has complained of an change magnitude cough productive of green sputum over the last week. She also complained of being increasingly pitiful of breath, and she is noticeably wheezing on physical examination. Arterial line of credit was drawn and sampled, breaching the following setpH 7.30pCO2 50 mm HgpO2 55 mm HgHemoglobin O2saturation45 %HCO3- 24 meq / literQuestions1. How would you classify this girls acid-base status?2. How does cystic fibrosis cause this acid-base imbalance?3. How would the kidneys try to vivify for the girls acid-base imbalance? 4. List some other causes of t his type of acid-base disturbance. Vignette 2A 76-year-old man complained to his married woman of severe sub-sternal chest pains that radiated down the inside of his left arm.Shortly afterward, he collapsed on the hold room floor. Paramedics arriving at his house just minutes later found him unresponsive, not alive, and without a pulse. cardiopulmonary resuscitation and electroconvulsive shock were required to start his heart beatingagain. Upon arrival at the Emergency Room, the man started to incur consciousness, complaining of severe shortness of breath (dyspnea) and continued chest pain. On physical examination, his vital signs were as follows Systemic blood 85 mm Hg / 50 mm pressure Hg perfume 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 testing revealed markedly elev ated creatine phosphokinase (CPK) levels 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 form started to compensate for this acid-base disturbance? 8. List some other causes of this type of acid-base disturbance. Vignette 3An elderly adult male is in a coma after suffering a severe stroke. He is in the intensifier 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 some other causes of this type of acid-base disturbance.