Case Vignettes in Acid-Base Balance Essay

prefer three of the four vignettes and BRIEFLY answer the questions that follow. Normal Levels of Substances in the Arterial BloodpH 7.40 + 0.05pCO2 (partial air pressure of carbon dioxide) 40 mm HgpO2 (partial pressure of oxygen) 90 100 mm Hg haemoglobin O2 saturation 94 100 %HCO3- 24 meq / lambertVignette 1A 14-year-old young woman with cystic fibrosis has complained of an increased cough productive of green sputum over the last week. She also complained of be increasingly short of intimation, and she is noticeably wheezing on physical examination. Arterial line of descent was drawn and sampled, telling the following valuespH 7.30pCO2 50 mm HgpO2 55 mm Hg haemoglobin O2saturation45 %HCO3- 24 meq / literQuestions1. 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 some(prenominal) former(a) causes of this type of acid-base dis turbance. Vignette 2A 76-year-old man complained to his wife of severe sub-sternal chest pains that radiated dismantle the inside of his left arm.Shortly by and byward, he collapsed on the living room floor. Paramedics arriving at his house moreover splendids later found him unresponsive, not breathing, and without a pulse. CPR and electroconvulsive shock were required to start his meaning 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 weak everywhere, and his skin was common cold and clammy. An ECG was done, revealing significant Q waves in most of the leads. Blood testing revealed markedly elevated creatine phosphokinase (C PK) 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 say 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 patient 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.