Complete the following case study:

A patient is a 35 year -old female with AIDS brought to the emergency room with a fever of 39oC and a three month history of copious diarrhea.

On physical exam the patient is a well-developed, thin female in moderate distress. Vital signs-(supine) blood pressure 100/60, pulse 100 and (standing) blood pressure 80/40, pulse 125, respirations 18 and she was febrile. Cardiac exam is within normal limits. Lungs were clear to auscultation and percussion. The abdomen was supple and minimally tender to palpation. Bowel sounds were hyperactive. Stool was guiac negative (no blood in stool). Extremities were without cyanosis, clubbing or edema. Neurological exam was intact.

Her arterial blood gas results:

pH: 7.33

Bicarb: 14

CO2: 40



What is/are the critical course of events that is going to alter her acid-base status? (5 points)





What acid base abnormalities would you expect based on this information and why? (5 points)





Review her blood gas. What is the primary acid-base abnormality? How did you decide that? (5 points)





Extra credit: If her respiratory drive were to alter itself, in order to help correct her imbalance, what kind of respiratory or breathing changes would you expect to see (how could the patient’s breathing change to compensate for the disturbance)??? (3 points)