Patient B would need to be assessed first. He has high potassium and HCO3 levels. He
also has low magnesium and calcium and a low pH level. The high potassium accompanied by
low pH, calcium, and magnesium can cause dysrhythmias. Excessive amounts of potassium can
also “shift to the intravascular space, which can be dangerous (especially within the heart)”
(Story, 2018, p. 170). High calcium and low pH can also lead to a coma. Patient B is at greater
risk for developing a heart condition. “Hyperkalemia refers to serum potassium levels greater
than 5mEq/L” (Story, 2018, p. 170). Some causes of hyperkalemia can include Addison’s
disease, Gordon’s syndrome, and certain medications like potassium sparing drugs and
angiotensin-converting enzyme inhibitors. Low magnesium levels otherwise known as
hypomagnesemia can cause numbness and tingling. Low calcium levels also known as
hypocalcemia can cause “tingling of the feet, fingers, tongue and lips” (Burke, 2019). A possible
etiology that can be associated with the patient’s hypocalcemia is either “ too much calcium is
lost in urine or not enough calcium is moved from bones into the blood” (Lewis, 2018).
Hypomagnesemia can be caused by “decreased absorption of magnesium in the gut or increased
excretion of magnesium in the urine” (Dix, 2017). Some conditions that can aid in the
manifestation of low magnesium can include “gastrointestinal (GI) diseases, advanced age, type
2 diabetes, use of loop diuretics (such as Lasix), treatment with certain chemotherapies, and
alcohol dependence” (Dix, 2017).
Manifestations that can be associated with hyperkalemia would be muscle weakness,
paresthesia, bradycardia, dysrhythmias, nausea, and diarrhea. Manifestations that can be
associated with hypocalcemia can include anxiety, depression, tremors, lethargy, seizures, and
muscle spasms. Manifestations that can be apparent in a patient with hypomagnesemia can be
personality changes, seizures, tingling, nausea, and decreased appetite. To analyze the patient's
arterial blood gases you would start off by analyzing the patient’s pH, PaCO2, and HCO3 levels.
The pH is less than 7.4 so you will label it with an A. The PaCO2 is high so you will label it with
an A. The HCO3 level is high so you will label it with a B. The two A’s pair up leaving the B
unpaired. The patient still has an abnormal pH level with the B being different from the two A’s.
This means that it is partially compensated. Because we have two A’s and one of them is the
PaCO2, we can now determine that the disorder is respiratory. The renal system will attempt to
compensate. “The renal system affects pH by reabsorbing bicarbonate and excreting fixed acids”
(Hopkins & Sharma, 2019).
also has low magnesium and calcium and a low pH level. The high potassium accompanied by
low pH, calcium, and magnesium can cause dysrhythmias. Excessive amounts of potassium can
also “shift to the intravascular space, which can be dangerous (especially within the heart)”
(Story, 2018, p. 170). High calcium and low pH can also lead to a coma. Patient B is at greater
risk for developing a heart condition. “Hyperkalemia refers to serum potassium levels greater
than 5mEq/L” (Story, 2018, p. 170). Some causes of hyperkalemia can include Addison’s
disease, Gordon’s syndrome, and certain medications like potassium sparing drugs and
angiotensin-converting enzyme inhibitors. Low magnesium levels otherwise known as
hypomagnesemia can cause numbness and tingling. Low calcium levels also known as
hypocalcemia can cause “tingling of the feet, fingers, tongue and lips” (Burke, 2019). A possible
etiology that can be associated with the patient’s hypocalcemia is either “ too much calcium is
lost in urine or not enough calcium is moved from bones into the blood” (Lewis, 2018).
Hypomagnesemia can be caused by “decreased absorption of magnesium in the gut or increased
excretion of magnesium in the urine” (Dix, 2017). Some conditions that can aid in the
manifestation of low magnesium can include “gastrointestinal (GI) diseases, advanced age, type
2 diabetes, use of loop diuretics (such as Lasix), treatment with certain chemotherapies, and
alcohol dependence” (Dix, 2017).
Manifestations that can be associated with hyperkalemia would be muscle weakness,
paresthesia, bradycardia, dysrhythmias, nausea, and diarrhea. Manifestations that can be
associated with hypocalcemia can include anxiety, depression, tremors, lethargy, seizures, and
muscle spasms. Manifestations that can be apparent in a patient with hypomagnesemia can be
personality changes, seizures, tingling, nausea, and decreased appetite. To analyze the patient's
arterial blood gases you would start off by analyzing the patient’s pH, PaCO2, and HCO3 levels.
The pH is less than 7.4 so you will label it with an A. The PaCO2 is high so you will label it with
an A. The HCO3 level is high so you will label it with a B. The two A’s pair up leaving the B
unpaired. The patient still has an abnormal pH level with the B being different from the two A’s.
This means that it is partially compensated. Because we have two A’s and one of them is the
PaCO2, we can now determine that the disorder is respiratory. The renal system will attempt to
compensate. “The renal system affects pH by reabsorbing bicarbonate and excreting fixed acids”
(Hopkins & Sharma, 2019).
