M2 Case Study.docx - 1 Sickle Cell Case Study Brenda Arnett College of Nursing and Health Innovation University of Texas at Arlington NURS 5315 Advanced

M2 Case Study.docx - 1 Sickle Cell Case Study Brenda Arnett...

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1 Sickle Cell Case Study Brenda Arnett College of Nursing and Health Innovation, University of Texas at Arlington NURS 5315: Advanced Pathophysiology Misti Tuppeny, MSN, APRN, CNS, CCRN, CNRN, CCNS March 7, 2020
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2 1. The clinical scenario is most consistent with which acid base disorder? Normal gap hyperchloremic metabolic acidosis (Desai et al, 2018) 2. What data in the clinical scenario supports your diagnosis? Interpret the labs you list as part of the answer by indicating if they are normal, high, or low. Profuse diarrhea and fever for 3 days Tachypnea, rate of 24 Tachycardia, rate of 117 "Low" CO 2 of 18 mEq/L, normal is 23-30 mEq/L. (Pagana & Pagana, 2001, pp. 206-207) "High" Hyperkalemia, of 5.5 mEq/L, normal is 3.5-5 mEq/L. (Pagana & Pagana, 2001, pp. 676-678) "Normal" Anion Gap of 10 mEq/L, normal values are based on whether K + is included in the value or not, but can be from 8-16 mEq/L. (Pagana & Pagana, 2001, pp. 67-68) 3. What caused this person’s acid base imbalance? Increased water and bicarbonate loss from profuse diarrhea and fever for three days. Bicarbonate is normally secreted into the intestines to neutralize acid from the stomach. In the presence of profuse diarrhea, the pancreas and intestinal mucosa secretes more bicarbonate and all is lost due to increased gastric motility, leading to acidosis (Sandeep et al, 2020).
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