NUR-641E: Classification of Patients Acid-Base Disturbance

FOCUSED ASSESSMENT
By:
Institutional Affiliation:
Acid-Base Balance
Focused History
As provided in the case study, a 22 –year-old woman is reported to be suffering from flu over the past 8 days. According to the reports collected, the patient experiences several vomits a day, with difficulties in keeping food or liquids down. On the other hand, the patient has been using more than the required doses of antacids with the aim of calming her nausea, an aspect that has resulted to her dehydration (Green & Siegler, 2016). The patient is reported to have fainted at home and taken to a local medical institution. At the institution, the patient’s arterial blood gas samples were drawn after which an IV was placed to help in rehydrating her. The results were collected and established as provided in the case study.
Classification of the Patient’s Acid-Base Disturbance
In this case and in accordance to the results of the tests, it is evident that the patient is in a metabolic alkalosis state since her pH is significantly higher at 7.5, thus indicative of the fact that the patient may be suffering from Alkalosis. On the other hand, the patients HCO3 (i.e., bicarbonate) is considerably higher and stands at 32 mEq/L, an aspect that further indicates that the patient’s condition is rather metabolic and not respiratory, an aspect that clearly proves the fact that she is suffering from a metabolic alkalosis.
Physical Exam
Given the case of the patient, it is of significant essence to determine that metabolic acidosis occurs in instances where the body is bound to produce more acids while the kidneys are unable to extract them properly (Green & Siegler, 2016). In this case, it is essential to consider that the blood needs the right balance of basic and acidic compounds in order to function efficiently, an aspect that is referred to as the acid-base balance. The kidneys and lungs therefore need to maintain their acid-base balance since slight variations would significantly affect the vital organs. Acid and alkaline levels are in this case measures through the use of a pH scale in which an increase in the acidity levels may result in the fall of the pH levels while a fall may clearly indicate a rise in the pH levels.
The Possible Factors Causing this Acid-Base Disturbance
Under normal instances, the arterial blood pH is restricted to a narrow level of 7.35 to 7.45. In this case, a patient presenting a blood pH that is lower that the pH of 7.35 is perceived to be in acidosis since the blood is not acidic until the pH drops below 7. On the other hand, a patient presenting a blood pH above 7.45 is in alkalosis since a pH that is above 7.8 is considered as fetal. Given the findings indicated in the case study provided, it is essential to consider that there are several aspects that would cause acidic-base disturbances. These factors therefore include the instances of several vomits experienced in the patient’s condition, the difficulties experienced in keeping food and liquids down and the excessive use of antacids to calming her nausea (Kreü et al, 2017). Along with the proponents of respiratory compensation, it is vital to establish that the patient’s kidneys extract excess bica...