Acid Base Disorder Case Study

Case Study 1

Acid Base Disorder

Abstract

Two case studies are presented. In the first a 21-year-old woman with an eight year history of juvenile onset diabetes was brought to the hospital in a coma. She required 92 units of insulin daily to maintain her blood glucose concentration, which was at 1,200 mg/dL. When admitted she had a low blood pressure of 92/20, an increased heart rate of 122 beats/min and an increased respiratory rate of 32/min. After examining the lab results insulin was administered as well as sodium bicarbonate to counteract the chronic metabolic acidosis. The second case study reviewed a 14-year-old boy who contracted poliomyelitis and was hospitalized. He required the use of a respirator during the acute phase of his illness. He appeared to be recovering however his lab results showed signs of respiratory acidosis which is most likely due to the trauma his respiratory muscles experienced.

Part One

Doctors Notes

* 21 year old patient has an eight year history of diabetes currently in coma

* Requires 92 units of insulin daily

* BP 92/20 mmHg

* Pulse 122 beats/min

* Respiratory rate of 32/min

* Her glucose level is 1200 mg/dL

* Her pH is acidic at 7.1

* Her pCO2 levels are low at 15 mmHg

* Her HCO3 is love at 4 mmol/L

* Her sodium levels are low at 129 mmol/L and her Potassium levels are high at 6.4 mmol/L

* Her urea nitrogen levels are high at 74 mg/dL

* Total CO2 is love at 5 mmol/L

* Creatinine levels are high at 2.3 mg/dL

Patients Lab Results

| Value | | Value | | Value |

pH | 7.10 | Na+ | 129 mmol/L | Total CO2 | 5 mmol/L |

pCO2 | 15 mmHg | K+ | 6.4 mmol/L | Glucose | 1200 mg/dL |

pO2 | 90 mmHg | Cl- | 95 mmol/L | Creatinine | 2.3 mg/dL |

HCO3 | 4 mmol/L | Urea Nitrogen | 74 mg/dL | | |

Normal Lab Results

| Value | | Value | | Value |

pH | 7.35-7.45 | Na+ | 135-145 mmol/L | Total CO2 | 24-30 mmol/L |

pCO2 | 35-45 mmHg | K+ | 3.5 – 5.0 mmol/L |...