1. Sandy, a 16-year-old woman, returns to the emergency room for the fifth time. She has been treated for Bulimia repeatedly. On initial assessment, you note shallow breathing.

ARTERIAL BLOOD GASES are as follows:
pH = 7.45
PaCO2 =47 mmHg
HCO3- = 33 mEq/Liter
My answer is Complete Compensated Respiratory Acidosis but I'm a little iffy about it because bulimia can be prolonged vomiting which can cause metabolic alkalosis, while the shallow breathing can cause respiratory acidosis.

2. Mitch, age 36 is admitted to the ER for an acute onset of an asthma attack. The asthma attach has lasted at least one hour before blood gases are drawn.
ARTERIAL BLOOD GASES are as follows:
pH = 7.10
PaCO2 = 80 mmHg
HCO3- = 25 mEq/Liter
My Answer: Uncompensated Respiratory Acidosis

3. Cassandra has Type I diabetes. She had the flu for the last 3 days and has lost her appetite. In addition, she has neglected to administer her insulin shots. Upon admission, you note that her breathing is heavy and her breath is fruity in odor
ARTERIAL BLOOD GASES are as follows:
pH = 7.30
PaCO2 = 23 mmHg
HCO3- = 9 mEq/Liter
My answer: Partially Compensated Metabolic Acidosis

4. Chad has been admitted to the ER for passing out during an A & P Exam. Prior to the exam his classmates
noticed that he was hyperventilating and expressed nervousness because he had not studied.
ARTERIAL BLOOD GASES are as follows:
pH = 7.50
PaCO2 = 29 mmHg
HCO3- = 24 mEq/Liter
My answer: Uncompensated Respiratory Alkalosis

1. Sandy's symptoms and arterial blood gas values suggest a mixed acid-base disturbance. Bulimia, which involves recurrent episodes of binge eating followed by purging, can lead to metabolic alkalosis due to the loss of gastric acid through vomiting. However, shallow breathing can result in respiratory acidosis. In this case, the arterial blood gas values show an increased PaCO2 (respiratory acidosis) and an increased HCO3- (metabolic alkalosis). The pH is normal, which indicates compensation. Therefore, a more appropriate answer would be a mixed disturbance with respiratory acidosis and metabolic alkalosis.

2. Mitch's symptoms and arterial blood gas values indicate respiratory acidosis. His asthma attack leads to impaired ventilation and increased retention of CO2 (elevated PaCO2). The pH is low, indicating acidosis, and there is no compensation observed in the HCO3- level. Therefore, the correct answer is uncompensated respiratory acidosis.

3. Cassandra's symptoms and arterial blood gas values suggest metabolic acidosis. The fruity breath odor and heavy breathing indicate that she might have diabetic ketoacidosis, a complication of uncontrolled type I diabetes. The low pH suggests acidosis, and the low HCO3- level further supports metabolic acidosis. However, the PaCO2 is lowered, indicating respiratory compensation. Thus, the correct answer is partially compensated metabolic acidosis.

4. Chad's symptoms and arterial blood gas values point to respiratory alkalosis. Hyperventilation, which causes excessive elimination of CO2, can result in respiratory alkalosis. The elevated pH and reduced PaCO2 levels support this diagnosis. There is no evidence of compensation in the HCO3- level. Therefore, the correct answer is uncompensated respiratory alkalosis.