Fluid and Electrolyte Abnormalities

Chapter 62 Fluid and Electrolyte Abnormalities




Clinical Case Problem 1 A 72-Year-Old Man with Chronic Obstructive Pulmonary Disease


A 72-year-old man with chronic obstructive pulmonary disease (COPD) is seen in the emergency department. During the past 2   days, he has experienced a worsening cough with yellow-brown sputum production and fever (temperature to 101° F). On examination, his respiratory rate is 26 breaths/minute using accessory muscles. His arterial blood gas (ABG) values on room air are as follows: pH, 7.24; PaO2, 54   mm Hg; SaO2, 88%; PaCO2, 60   mm Hg; and image, 27   mEq/L.



Select the best answer to the following questions




1. Which process is disturbing the acid-base balance?


a. metabolic acidosis

b. respiratory alkalosis

c. metabolic alkalosis

d. respiratory acidosis

e. none of the above


Clinical Case Problem 2 A 22-Year-Old Woman Who Is Dizzy and Has Tingling Around Her Mouth and Fingertips


A 22-year-old woman comes into the emergency department with dizziness and tingling around her mouth and fingertips. Her blood pressure is 140/70   mm Hg, pulse is 110 beats/minute,


respiratory rate is 30 breaths/minute, and temperature is 98.6° F. Her ABG values on room air are as follows: pH, 7.52; PaO2, 90   mm Hg; SaO2, 97%; PaCO2, 25   mm Hg; and image, 18   mEq/L.



2. Which process is disturbing the acid-base balance?


a. metabolic acidosis with respiratory compensation

b. respiratory alkalosis with metabolic compensation

c. metabolic alkalosis without respiratory compensation

d. respiratory acidosis with metabolic compensation

e. none of the above


Clinical Case Problem 3 A 28-Year-Old Pregnant Woman with Persistent Vomiting


A 28-year-old woman in the first trimester of pregnancy comes into the emergency department with several days of morning sickness with persistent vomiting. She is now lethargic. Her blood pressure is 90/60   mm Hg, pulse is 120 beats/minute, respiratory rate is 10 breaths/minute, and temperature is 99° F. Her ABG values on room air are as follows: pH, 7.5; PaO2, 80   mm Hg; SaO2, 94%; PaCO2, 49   mm Hg; and image, 38   mEq/L.



3. Which process is disturbing the acid-base balance?


a. metabolic acidosis with respiratory compensation

b. respiratory alkalosis without metabolic compensation

c. metabolic alkalosis with respiratory compensation

d. respiratory acidosis with metabolic compensation

e. none of the above


Clinical Case Problem 4 A 60-Year-Old Man Resuscitated in the Cardiac Care Unit


A 60-year-old man, admitted to the cardiac care unit for chest pain, suddenly becomes unresponsive in cardiac arrest with asystole. He never stops breathing spontaneously but he requires chest compressions and epinephrine during the event. A normal sinus rhythm is obtained after a 3-minute code. His ABG values on 2   L/min of O2 by nasal cannula are as follows: pH, 7.28; PaO2, 130   mm Hg; SaO2, 100%; PaCO2, 28   mm Hg; and image, 14   mEq/L. His blood test values are as follows: Na+, 140   mEq/L; K+, 5.6   mEq/L; Cl–, 100   mEq/L; CO2, 14   mEq/L; glucose, 130   mg/dL; creatinine, 1.2   mg/dL; and blood urea nitrogen, 25   mg/dL.



4. Which process is disturbing the acid-base balance?


a. metabolic acidosis with respiratory compensation

b. respiratory alkalosis with metabolic compensation

c. metabolic alkalosis with respiratory compensation

d. respiratory acidosis with metabolic compensation

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Oct 1, 2016 | Posted by in GENERAL SURGERY | Comments Off on Fluid and Electrolyte Abnormalities

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