An ICU patient in septic shock shows the following electrolyte panel results: a serum Na⁺ of 150 mmol/L, a total CO₂ of 18 mmol/L, lactate of 4 mmol/L, and a serum Cl^– level of 110 mmol/L. The patient is hypotensive and the RT is unable to obtain an ABG for analysis. What conclusion(s) can be drawn regarding this patient’s acid-base status?
1. The anion gap is decreased.
2. Metabolic acidosis is present.
3. Anion gap is increased.
4. Lactic acidosis is present.

Question

Quizplus · Accepted Answer

The anion gap is calculated using the formula: Na - (Cl + HCO3), and with the given values (Na=150, Cl=110, HCO3=18), the anion gap is 22 mmol/L, which is higher than the normal range (8-16 mmol/L), indicating an increased anion gap. The presence of a high lactate level (4 mmol/L) suggests lactic acidosis, a form of metabolic acidosis.

An ICU Patient in Septic Shock Shows the Following Electrolyte