A nurse is taking care of an 85-year-old woman in a hospital based skilled nursing facility. In report, the nurse is told the patient has not been breathing well for the past 2 days. She has been lethargic, her skin is warm and dry, and she has a decreased urine output. The following laboratory findings were returned from the laboratory immediately after morning report:
- Na: 147
- Cl 110
- K 4.0
- Blood Gases:
- pH 7.33
- PCO2 48
- HCO3 27
- Po2 96
- Urine Specific Gravity 1.040
Address the following:
- Identify each of the abnormal laboratory findings in the above results. Specify how they differ from a normal range and identify what condition each abnormality indicates.
- What specific electrolyte disturbance does the patient have?
- What clinical manifestations would the nurse expect to see with this electrolyte abnormality presented above?
- If the patient had an increase in her potassium level, what clinical manifestations would the nurse monitor for?
- What blood gas abnormality is seen in this patient? Discuss the rationale for your answer.
- What are the three major mechanisms of pH regulation.