A 50yearold man came to the emergency department after retur

A 50-year-old man came to the emergency department after returning from a foreign travel. His symptoms included persistent diarrhea (over the past 3 days_ and rapid respiration (tachypnea). Blood gases were drawn with the following results: pH 7.21 pCO2 19 mm Hg pO2 96 mm Hg HCO3 7 mmol/L SO2 96% (calculated) (reference range, >95%) 1. Why does the patient have rapid respiration? If the patient is suffering from one of the following conditions, what would you expect the following to be? Indicate increase, decrease, or normal after each lab test. Disorder Lab tests Renal Acidosis Anion gap BUN Creatinine Diarrhea Anion gap Chloride Lactic acidosis Anion gap Lactic acid Drug intoxication Drug screen

Solution

The patient has lower blood pH [7.35 to 7.45] which is suggesting that patient has acidosis. Lower pCO2 level [41-57 mmhg]. So, It is not the case of respiratory acidosis because of low pCO2 level. It is the case of metabolic acidosis. During diarrhea, HCO3 loses so the level of HCO3 is also very low [22-26mmol/L]. The lower sPO2 level is may occurred by a foreign travel which the patient had. It can also developed by others too like poor circulation, nail polish, and cold peripheries. Moreover, anion gap analysis can use for diagnosis. The tachypnea develops in such patient because of less saturation of oxygen and loss of HCO3 ions. The kidneys do not work properly to excrete excess acids of body. The blood gets acidic and brain then orders to increase the rate of respiration to meet the normal pH of blood.