A 61 year-old man with amyotrophic lateral sclerosis is brought into clinic by his family who are

concerned that he is more somnolent than normal. On further history, they report that he has
been having problems with morning headaches and does not feel very refreshed when he
wakes up. An arterial blood gas is performed and reveals: pH 7.37, PCO2 57, PO2 70, HCO3 -
32.

What is the patient's Acid-base status?

Explanation for the clinical picture:

Question

Interpret the ABG results and explain the acid-base imbalance that occurred to this patient.

Case scenario

A 68-year-old client admitted with pneumonia secondary to COVID-19 has the following ABG
results:

pH = 7.46

PaCO2 = 30

HCO4 = 19

SaO2 = 72

case Scenario:

S.M. is a 68-year-old man who is being seen at the clinic for a routine health maintenance and
health promotion. He reports he has been feeling well and has no specific complaints, except for
some trouble’s “emptying my bladder”. Vital signs (VS) at his visit are; BP= 148/88 mmHg, PR=
82 bpm, RR= 16cpm, Temp.= 96.7 °F (36.1 °C). he had a CBC and complete metabolic panel
(CMP) completed 1 week before his visit, and the results are listed below.

Laboratory Test Result

Sodium                                                                 140 mEq/L

Potassium                                                             4.2 mEq/L

Chloride                                                               100 mEq/L

pH                                                                          7.32

PaCO2                                                                   43 mmHg
Bicarbonate                                                           28 mEq/ L

BUN                                                                       19 mg/dL

Creatinine                                                               0.8 mg/dL

Glucose                                                                  94 mg/dL

RBC                                                                        5.2 million/mm³

WBC                                                                      7400/ mm³

Hgb                                                                        15.2 g/dL

Hct                                                                          46%

Platelets                                                                348,000/mm³

Prostate – specific antigen (PSA)                        0.23 ng/mL

Urinalysis                                                                WNL

What are the F&E imbalances involved?

Interpret and explain S. M. laboratory findings.