A 22-year-old woman reports being “sick with the flu” for the past 8 days. She is vomiting several times every day, having difficulty keeping liquids or food down, and has been using more than the recommended dose of antacids in an attempt to calm the nausea. She has become severely dehydrated. After fainting at home, she was taken to a local hospital. An arterial blood gas sample was drawn and then an IV was placed to help rehydrate her. The arterial blood gas revealed the following:

Test                                                     Result                                               Normal levels

pH                                                                   7.5                                                       7.35 – 7.45

PaCO₂                                                 40 mm Hg                               35-45 mm Hg

PaO₂                                                    95 mm Hg                               80-100 mm Hg

SaO₂                            97%                                         95-100%

HCO₃–                                           32 meq/liter                       22-26 meq/liter

 

How would you classify the patient’s acid-base disturbance and explain why?

Given the case study, what are the possible factors causing this acid-base disturbance? Explain the pathophysiology created by these factors.

How would the renal and respiratory systems try to compensate for this acid-base disturbance?

What pharmacologic intervention is commonly used to correct this acid-base disturbance? Describe the pharmacological actions.

Describe the educational needs for this patient and what your approach will be.