Thursday, October 4, 2012

Hypothetically with knowing how to identify one who is having a acid-base deficit could I diagnosis someone


Hypothetically with knowing how to identify one who is having a acid-base deficit could I diagnosis someone?
I was recently taught in the nursing program about acid and bases in my pathophysiology class and now just finished the course. If for example a patient comes into ER with symptoms of feeling fatigue and having a distinguish fruity smell from their breath. I suspect ketoneacidosis and that he/she may have type 1 diabetes mellitus. With getting the lab values back from the lab I see that his/her blood serum ph is 7.45 , PCO is 30mmHg and the HCO is 28mmHg. With knowing this I see that the patient is experiencing Respiratory Alkaline with a complete metabolic compensate. I this a possible diagnosis or even a proper one? With this knowledge of being able to figure out someone who is with such symptoms and then seeing on their lab values and such and making a diagnosis is possible? I know I can't really make a diagnoses and that only can a physician do so, but I was just wondering out of curiosity? Thanks! note: HCO is 20mmHg not 28mmHg
Other - Diseases - 1 Answers
Random Answers, Critics, Comments, Opinions :
1 :
A patient with the fruity smell on their breath is going to be a Diabetic Ketoacidosis patient, Acidosis being the key factor there. They breathe fast in order to blow off the carbon dioxide which is causing the acidosis. I think that a PH of 7.45 is very unlikely in this situation. The diagnosis should be Comensated metabolic alkylosis. Normal lab values for HCO is 22-26, so that is elevated and causing the high end of normal on the PH. The PCO normal range is 35-45, it is decreased to compensate for the high bicarb. Bottom line, the Bicarb value is high. The respiratory factor PCO is low to compensate for the high bicarb. Hope this helps!






Read more discussions :
Posted by Diabetes Melitus at 9:51 AM