Case Vignettes in Acid-Base Balance Essay

Choose terzetto of the four vignettes and BRIEFLY answer the questions that follow. Normal Levels of Substances in the Arterial argumentpH 7.40 + 0.05pCO2 (partial instancy of carbon dioxide) 40 mm HgpO2 (partial gouge of oxygen) 90 100 mm Hghemoglobin O2 saturation 94 100 %HCO3- 24 milliequivalent / literVignette 1A 14-year-old girl with cystic fibrosis has complained of an increased cough productive of green indifference over the last week. She also complained of being increasingly short of jot, and she is noticeably wheezing on physical examination. Arterial blood was drawn and sampled, unveil the following valuespH 7.30pCO2 50 mm HgpO2 55 mm HgHemoglobin O2saturation45 %HCO3- 24 meq / literQuestions1. How would you classify this girls acid-base billet?2. How does cystic fibrosis safari this acid-base imbalance?3. How would the kidneys try to compensate for the girls acid-base imbalance? 4. come somewhat different causes of this type of acid-base disturbance. Vig nette 2A 76-year-old humankind complained to his wife of severe sub-sternal chest pains that radiated down the inside of his left wing arm.Shortly afterward, he collapsed on the living room floor. Paramedics arriving at his field of operations just minutes later found him unresponsive, not breathing, 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 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 unaccented everywhere, and his skin was cold and clammy. An ECG was done, revealing significant Q waves in near of the leads. Blood testing revealed markedly elevated creat ine phosphokinase (CPK) levels of cardiac tendon 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 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 a cid-base disturbance? 12. List some other causes of this type of acid-base disturbance.