An overweight 55-year-old single woman from a rural farming area was brought to the emergency department by her neighbor.The woman had a large abscess on the bottom of her foot; she was irritable and complained of blurred vision and of being thirsty.Her breathing was rapid.The neighbor said that the only medication the woman was using was for blood pressure and sometimes an aspirin.Blood and urine samples were collected.Arterial blood gas results were: pH 7.2; PCO₂ 47 mm Hg; HCO₃ 8 mmol/L.Blood glucose was 340 mg/dL and a high anion gap was calculated.Urine glucose and ketones were markedly increased.Based on the laboratory values,what state of acid-base balance is this patient in?

Question

Quizplus · Accepted Answer

The patient is in a state of metabolic acidosis, as evidenced by the low arterial pH (7.2), low bicarbonate levels (8 mmol/L), and high anion gap. The elevated blood glucose and urine glucose and ketones suggest that the patient is experiencing diabetic ketoacidosis, which is a common cause of metabolic acidosis. The patient's symptoms of thirst, blurred vision, rapid breathing, and irritability are also typical of diabetic ketoacidosis. There is no evidence of respiratory acidosis or alkalosis based on the given information. There is also no evidence of metabolic alkalosis as the bicarbonate levels are low.

An Overweight 55-Year-Old Single Woman from a Rural Farming Area