A nurse is taking care of an 85-year-old woman in a hospital-based skilled nursing facility. In the 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
Arterial Blood Gases
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- 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?
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