Approach to acid-base disorders Quiz: Ace Your Exams
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A 72-year-old woman presents to the emergency department with a three-day history of vomiting and diarrhea. Her medical history is significant for hypertension which is typically well-controlled with hydrochlorothiazide. She reports no fever, chest pain or difficulty breathing. Temperature is 37.0 °C (98.6 °F), heart rate is 108/min, respiratory rate is 12/min, blood pressure is 96/60 mmHg and oxygen saturation is 100% on room air. On physical examination the patient has dry mucous membranes and diminished skin turgor. Laboratory studies are shown below. Based on these studies, what is the significance of this patient’s PaCO2 value?
| Test | Result | Reference Range |
| Chemistry | ||
| Sodium | 132 mEq/L | 136-146 mEq/L |
| Potassium | 3.1 mEq/L | 3.5-5 mEq/L |
| Chloride | 90 mEq/L | 95-105 mEq/L |
| Bicarbonate | 32 mEq/L | 22-28 mEq/L |
| Arterial blood gas | ||
| pH | 7.48 | 7.35-7.45 |
| PaCO2 | 49 mm Hg | 33-45 mm Hg |
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