SAQ 110 – Metabolic – acid-base disturbance and hyponatraemia

A 47-year-old man with chronic liver disease and schizophrenia is brought to the emergency department with acute confusion.

His observations are BP 120/60 mmHg, HR 120/min, RR 40/min, and GCS 12.

His arterial blood gas and biochemistry are shown below.

Arterial blood gas and biochemistry

Test	Result	Units	Reference range
FiO2	21	%
pH	7.30		7.35-7.45
pO2	91	mmHg	80-95
pCO2	15	mmHg	35-45
HCO3-	9	mmol/L	22-28
Lactate	14	mmol/L	< 2.0
Na+	101	mmol/L	134-146
K+	4.7	mmol/L	3.4-5.0
Cl-	73	mmol/L	98-106
Glucose	10.5	mmol/L	3.5-5.5

Provide two derived calculations that help interpret these results.

(Marked out of 2.0)

/ 2

List four likely explanations for this pattern of results.

(Marked out of 4.0)

/ 4

You assess him as moderately dehydrated. List four points in your approach to fluid replacement.

(Marked out of 4.0)

/ 4

Total Score: 0 / 10

Percentage: 0%