SAQ 628 – Metabolic – vomiting with hyperglycaemia and electrolyte disturbance

Marked out of 8.00

A 48-year-old woman presents after two days of vomiting. She is confused and cannot provide a clear history. Her examination and venous blood gas are shown below.

Observation Result
BP 100/82 mmHg
HR 144 bpm
Temperature 36.5 degrees C
RR 24 /min
O2 saturation 98% room air
GCS 13 (E4 M5 V4)
pH 7.38 (7.35-7.45)
pCO2 36 mmHg (35-45)
HCO3 21 mmol/L (22-26)
Base excess -3 (-1 to 1)
Lactate 3.3 mmol/L (0-2)
Glucose 22 mmol/L (3-6.5)
Na 129 mmol/L (135-145)
Cl 79 mmol/L

Provide two (2) calculations to assist with interpretation of these investigations.

(Marked out of 2.0)


/ 2

State your interpretation of the results, including three (3) points.

(Marked out of 3.0)


/ 3

State three (3) initial treatments, including aims where appropriate.

(Marked out of 3.0)


/ 3

Total Score: 0 / 8

Percentage: 0%