Question

Brian, an 80-year-old man with a history of chronic obstructive pulmonary disease (COPD) and respiratory infections, was admitted through the ER with a chronic cough and extreme dyspnea. He complained that he was unable to climb the stairs or anything that required any exertion (even washing his hair). He had been a heavy smoker but had been attempting to stop smoking by cutting back on the number of cigarettes per day. The nurse noted his temperature was 101.2 °F. Arterial Blood Gas Results Test Brian Reference Range pH 7.23 7.35–7.45 PCO2 75.0 35–45 mm Hg PO2 28.2 83–108 mm Hg HCO3 32.7 22–28 mEq/L SaO2 49.6 95–98% COHb 8.6 Nonsmoker: 0.5–1.5% Smokers: 1–2 packs/day: 4–5% > 2 Packs/day: 8–9% What is the primary compensatory mechanism in this acid-base disorder? A. List 3 processes it uses to compensate for the imbalance. B. What other system is responsible for the compensatory mechanisms in acid-base disorders, and how does it compensate? C. Why is it often inefficient in this acid-base disorder? Briefly describe base excess and base deficit, and would this patient have a base excess, deficit, or normal base? What conditions are associated with this acid-base disorder, and which condition is the most likely explanation for this case?

Brian, an 80-year-old man with a history of chronic obstructive pulmonary disease (COPD) and respiratory infections, was admitted through the ER with a chronic cough and extreme dyspnea. He complained that he was unable to climb the stairs or anything that required any exertion (even washing his hair). He had been a heavy smoker but had been attempting to stop smoking by cutting back on the number of cigarettes per day. The nurse noted his temperature was 101.2 °F.

Arterial Blood Gas Results
Test Brian Reference Range
pH 7.23 7.35–7.45
PCO2 75.0 35–45 mm Hg
PO2 28.2 83–108 mm Hg
HCO3 32.7 22–28 mEq/L
SaO2 49.6 95–98%
COHb 8.6 Nonsmoker: 0.5–1.5%
Smokers:
1–2 packs/day: 4–5%
> 2 Packs/day: 8–9%

What is the primary compensatory mechanism in this acid-base disorder? A. List 3 processes it uses to compensate for the imbalance. B. What other system is responsible for the compensatory mechanisms in acid-base disorders, and how does it compensate? C. Why is it often inefficient in this acid-base disorder?

Briefly describe base excess and base deficit, and would this patient have a base excess, deficit, or normal base?

What conditions are associated with this acid-base disorder, and which condition is the most likely explanation for this case?

Added by Paul G.