Conrad jackson is a 28-year-old man who presents to the emergency department with severe fatigue and dehydration secondary to a 4-day history of vomiting. during the interview, he describes attending a family reunion and states that perhaps he "ate something bad". upon admission his vital signs are a temperature of 102.7 f, heart rate of 116 bpm, respiratory rate of 18 breaths/min, and blood pressure of 86/54 mm hg. the nurse also notes the patient has dry mucuos membranes and tenting of skin. the physician orders an iv to be started with 0.45% normal saline, and orders a serum electrolytes and an arterial blood gas.
the following results are returned from the laboratory:
sodium (na+) 150
potassium (k+) 5.5
chloride (cl-) 110
bun 42
creatinine 0.8
glucose 86
ph 7.32
paco2 35
hco3 20
pao2 90
o2sat 98%
a. what is your interpretation of this arterial blood gas sample?
b. explain the high potassium in this patient.
c. calculate the patient's anion gap:
d. what is the interpretation of this anion gap?