Case Vignettes in Acid-Base Balance Essay

A 14-year-old girl with cystic fibrosis has complained of an increased cough productive of green sputum over the last week. She also complained of being increasingly little(a) of breath, and she is noticeably wheezing on physical examination. Arterial blood was drawn and sampled, revealing the following valuesQuestions1. 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 compensate for the girls acid-base imbalance? 4. List more or less other causes of this type of acid-base disturbance. Vignette 2A 76-year-old soldiery 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 room floor. Paramedics arriving at his house in force(p) minutes later found him unresponsive, not breathing, and without a pulse. CPR and electroconvulsive shock were required to start his heart beating again. Upon arrival at the Emergency Room, the humans started to regain 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 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 testing revealed markedly elevated 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 body started to compensate for this acid-base disturbance? 8. List som e 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 persevering 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.