Question

Case Study 1. Andrew, a 22-year-old male, was involved in a head-on collision. He was not wearing his seatbelt at the time of the accident. When emergency crews reached the scene of the accident they found Andrew wedged against the steering wheel. Following a difficult extraction from his vehicle, Andrew is exhibiting the following symptoms: - Semiconscious - Dyspnea - Inward movement of the left anterior portion of his thorax during inhalation - Pain in his left thorax and upper left abdomen - Pale and cyanotic mucous membranes and cyanotic areas around his upper lip and nail beds - BP 83/51 - CBC HgB 10.1, HcT 30% - Blood chemistry abnormalities Arterial PO2 65mmHg, Arterial PCO2 55mmHg, Arterial pH 7.27 - Urinalysis: pH 4.0

5. What kind of acid/base imbalance has Andrew developed?

6. Explain how this acid/base imbalance developed?

7. Is there evidence of homeostatic compensation occurring which will attempt to restore normal blood pH? If yes, what?

8. Before Andrew was removed from his demolished vehicle, his BP was 110/70. After he was extracted from his crushed car, his BP was 83/51. What is the explanation of this sudden change in BP?

Answer 1

QUESTION 1

The client is having respiratory acidosis.

QUESTION 2

Dyspnea and internal bleeding which is evidenced by cyanosis of the mucous membrane, upper lips and nail bed, decreased blood pressure and low urine pH- 4.0, that has caused respiratory acidosis.

QUESTION 3

Yes, the homeostatic compensation is there to restore normal pH. The kidney started the compensation by decreasing the urine pH to 4.0 which means that the anions are releasing in high amount in urine.

QUESTION 4

The sudden change in blood pressure occurred due to internal bleeding. Massive internal bleeding causes low blood volume in the body and caused a sudden drop in blood pressure