Printer Friendly

9 ABG case studies - a quick practice challenge.

Case Study 1

A patient recovering from surgery in the post-anesthesia care unit (PACU) is difficult to arouse two hours following surgery. The nurse in the PACU has been administering Morphine Sulfate intravenously to the client for complaints of post-surgical pain. The patient's respiratory rate is 7 per minute and demonstrates shallow breathing. The patient does not respond to any stimuli! You assesses the ABCs (Airway, Breathing, Circulation!) and obtains ABGs STAT! The STAT results come back from the laboratory and show: What's your interpretation?

pH = 7.15

Pa C02 = 68 mmHg

HC03 = 22 mEq/L

A: Compensated Respiratory Acidosis

B: Uncompensated Metabolic Acidosis

C: Compensated Metabolic Alkalosis

D: Uncompensated Respiratory Acidosis

Case Study 2

An infant, three weeks old, is admitted to the Emergency Room. The mother reports that the infant has been irritable, difficult to breastfeed and has had diarrhea for the past 4 days. The infant's respiratory rate is elevated and the fontanels are sunken. The Emergency Room physician orders ABGs after assessing the ABCs.

The results from the ABGs come back from the laboratory and show: What's your interpretation?

pH = 7.37

Pa C02 = 29 mmHg

HC03 = 17 mEq/L

A: Compensated Respiratory Alkalosis

B: Uncompensated Metabolic Acidosis

C: Compensated Metabolic Acidosis

D: Uncompensated Respiratory Acidosis

Case Study 3

A patient, 5 days post-abdominal surgery, has a nasogastric tube. You note that the nasogastric tube (NGT) is draining a large amount (900 cc in 2hours) of coffee ground secretions. The patient is not oriented to person, place, or time. The nurse contacts the attending physician and STAT ABGs are ordered. The results from the ABGs come back from the laboratory and show: What's your interpretation?

pH = 7.52

Pa C02 = 35 mmHg

HC03 = 29 mEq/L

A: Compensated Respiratory Alkalosis

B: Uncompensated Metabolic Acidosis

C: Compensated Metabolic Acidosis

D: Uncompensated Metabolic Alkalosis

Case Study 4

A patient is admitted to the hospital and is being prepared for a craniotomy. The patient is very anxious and scared of the impending surgery. He begins to hyperventilate and becomes very dizzy. The patient looses consciousness and the STAT ABGs reveal: The results from the ABGs come back from the laboratory and show: What's your interpretation?

pH = 7.57

Pa C02 = 26 mmHg

HC03 = 24 mEq/L

A: Compensated Metabolic Acidosis

B: Uncompensated Metabolic Acidosis

C: Uncompensated Respiratory Alkalosis

D: Uncompensated Respiratory Acidosis

Case Study 5

A two-year-old is admitted to the hospital with a diagnosis of asthma and respiratory distress syndrome. The father of the infant reports to the nurse that he has observed slight tremors and behavioral changes in his child over the past three days. The attending physician orders routine ABGs following an assessment of the ABCs. The ABG results are: What's your interpretation?

pH = 7.36

Pa C02 = 69 mmHg

HC03 = 36 mEq/L

A: Compensated Respiratory Alkalosis

B: Uncompensated Metabolic Acidosis

C: Compensated Respiratory Acidosis

D: Uncompensated Respiratory Alkalosis

Case Study 6

A young woman, drinking beer at a party, falls and hits her head on the ground. A friend dials "911" because the young woman is unconscious, depressed ventilation (shallow and slow respirations), rapid heart rate, and is profusely bleeding from both ears. Which primary acid-base imbalance is this young woman at risk for if medical attention is not provided?

A: metabolic acidosis

B: metabolic alkalosis

C: respiratory acidosis

D: respiratory alkalosis

Case Study 7

An 11 -year old boy is admitted to the hospital with vomiting, nausea and overall weakness. The nurse notes the laboratory results: potassium: 2.9 mEq.

Which primary acid-base imbalance is this boy at risk for if medical attention is not provided?

A: metabolic acidosis

B: metabolic alkalosis

C: respiratory acidosis

D: respiratory alkalosis

Case Study 8

An elderly gentleman is seen in the emergency department at a community hospital. He admits to taking many tablets of aspirin (salicylates) over the last 24-hour period because of a severe headache. He complains of an inability to urinate. His vital signs are: Temp = 98.5; apical pulse = 92; respiration = 30 and deep.

Which primary acid-base imbalance is the gentleman at risk for if medical attention is not provided?

A: metabolic acidosis

B: metabolic alkalosis

C: respiratory acidosis

D: respiratory alkalosis

Case Study 9

A young man is found at the scene of an automobile accident in a state of emotional distress. He tells the paramedics that he feels dizzy, tingling in his fingertips, and does not remember what happened to his car. Respiratory rate is rapid at 34/minute. Which primary acid-base disturbance is the young man at risk for if medical attention is not provided?

A: metabolic acidosis

B: metabolic alkalosis

C: respiratory acidosis

D: respiratory alkalosis

ANSWERS

1: D

2: C

3: D

4: C

5: C

6: C

7: B

8: A

9: D

RELATED ARTICLE: AT A GLANCE

Metabolic Acidosis - Clinical Manifestations Hyperkalemia: shift of acid to ICF and K+ to the ECF anorexia, nausea, and vomiting warm, flushed skin cardiac dysrhythmias & CNS dysfunction headache, diarrhea, tremors

Metabolic Alkalosis - Clinical Manifestations cardiac dysrhythmias seizures; confusion; muscle twitching, agitation >pH;>HC03; normal PaCo2 or elevated if compensation occurs

Respiratory Acidosis - Clinical Manifestations > PaCo2; HC03 is normal or > with renal compensation vasodilatation cardiac dysrhythmias, tachycardia somnolence, decreased ventilation

Respiratory Alkalosis - Clinical Manifestations > pH; < PaC02; HC03 normal or low due to compensation nausea, vomiting, tingling of fingers
COPYRIGHT 2011 Focus Publications, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2011 Gale, Cengage Learning. All rights reserved.

 
Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:BLOOD GAS CASE STUDIES
Publication:FOCUS: Journal for Respiratory Care & Sleep Medicine
Article Type:Case study
Geographic Code:1USA
Date:Jan 1, 2011
Words:887
Previous Article:20 essentials for good presentations.
Next Article:A popular sleep medicine puts older adults at risk for falls and cognitive impairment.
Topics:

Terms of use | Privacy policy | Copyright © 2018 Farlex, Inc. | Feedback | For webmasters