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A 22-year-old woman reports being “sick with the flu” for the past 8 days.

A 22-year-old woman reports being “sick with the flu” for the past 8 days. A 22-year-old woman reports being “sick with the flu” for the past 8 days.Resource 1: Case StudyA 22-year-old woman reports being “sick with the flu” for the past 8 days. She is vomiting several times every day, having difficulty keeping liquids or food down, and has been using more than the recommended dose of antacids in an attempt to calm the nausea. She has become severely dehydrated. After fainting at home, she was taken to a local hospital. An arterial blood gas sample was drawn and then an IV was placed to help rehydrate her. The arterial blood gas revealed the following:A 22-year-old woman reports being “sick with the flu” for the past 8 days.Test                                                     Result                                               Normal levelspH                                                                   7.5                                                       7.35 – 7.45PaCO2                                                 40 mm Hg                               35-45 mm HgPaO2                                                    95 mm Hg                               80-100 mm HgSaO2                            97%                                         95-100%HCO3–                                           32 meq/liter                       22-26 meq/literORDER A PLAGIARISM-FREE PAPER HEREHow would you classify the patient’s acid-base disturbance and explain why?Given the case study, what are the possible factors causing this acid-base disturbance? Explain the pathophysiology created by these factors.How would the renal and respiratory systems try to compensate for this acid-base disturbance?What pharmacologic intervention is commonly used to correct this acid-base disturbance? Describe the pharmacological actions.Describe the educational needs for this patient and what your approach will be.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Top of FormAcid-Base Case Study Paper  1No Submission0.00%2Unsatisfactory75.00%3Less than Satisfactory80.00%4Satisfactory88.00%5Good92.00%6Excellent100.00%80.0 %Content A 22-year-old woman reports being “sick with the flu” for the past 8 days. 20.0 %Paper correctly classifies the acid-base disturbance and comprehensively explains why the case study fits the acid-base disturbance selected.No paper was turned in to grade.Paper incorrectly classifies the acid-base disturbance and/or does not explain why the case study fits the acid-base disturbance selected.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Paper incorrectly classifies the acid-base disturbance but explains why the case study fits the acid-base disturbance selected.Paper correctly classifies the acid-base disturbance and partially explains why the case study fits the acid-base disturbance selected.Paper correctly classifies the acid-base disturbance and adequately explains why the case study fits the acid-base disturbance selected.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Paper correctly classifies the acid-base disturbance and comprehensively explains why the case study fits the acid-base disturbance selected.20.0 %Paper analyzes the possible factors causing the acid-base disturbance and comprehensively explains the pathophysiology created by the causative factors.No paper was turned in to grade.Paper lacks a discussion of the possible factors causing the acid-base disturbance and/or lacks an explanation of the pathophysiology created by the causative factors.Paper insufficiently discusses the possible factors causing the acid-base disturbance and/or insufficiently explains the pathophysiology created by the causative factors.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Paper partially discusses the possible factors causing the acid-base disturbance and/or partially explains the pathophysiology created by the causative factors.Paper adequately discusses the possible factors causing the acid-base disturbance and adequately explains the pathophysiology created by the causative factors.Paper analyzes the possible factors causing the acid-base disturbance and comprehensively explains the pathophysiology created by the causative factors.20.0 %Paper comprehensively discusses how the renal and respiratory systems try to compensate for the acid-base disturbance.No paper was turned in to grade.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Paper lacks a discussion of how the renal and/or respiratory systems try to compensate for the acid-base disturbance.Paper insufficiently discusses how the renal and respiratory systems try to compensate for the acid-base disturbance.Paper partially discusses how the renal and respiratory systems try to compensate for the acid-base disturbance.Paper adequately discusses how the renal and respiratory systems try to compensate for the acid-base disturbance.Paper comprehensively discusses how the renal and respiratory systems try to compensate for the acid-base disturbance.10.0 %Paper comprehensively discusses the pharmacologic intervention(s) commonly used to correct the acid-base disturbance.No paper was turned in to grade.Paper lacks a discussion on the pharmacologic intervention(s) commonly used to correct the acid-base disturbance.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Paper insufficiently discusses the pharmacologic intervention(s) commonly used to correct the acid-base disturbance.Paper partially discusses the pharmacologic intervention(s) commonly used to correct the acid-base disturbance.Paper adequately discusses the pharmacologic intervention(s) commonly used to correct the acid-base disturbance.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Paper comprehensively discusses the pharmacologic intervention(s) commonly used to correct the acid-base disturbance.10.0 %Paper comprehensively describes the educational needs for the patient and what the student?s approach will be.No paper was turned in to grade.Paper lacks a discussion of the educational needs for the patient and what the student?s approach will be.Paper insufficiently describes the educational needs for the patient and what the student?s approach will be.Paper partially describes the educational needs for the patient and what the student?s approach will be.Paper adequately describes the educational needs for the patient and what the student?s approach will be.Paper comprehensively describes the educational needs for the patient and what the student?s approach will be.15.0 %Format and Style A 22-year-old woman reports being “sick with the flu” for the past 8 days. 5.0 %Paragraph Development and Transitions StyleNo paper was turned in to grade.Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs. Transitions are inappropriate to purpose and scope. Organization is disjointed.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are used as appropriate to purpose, discipline, and scope.A 22-year-old woman reports being “sick with the flu” for the past 8 days.There is a sophisticated construction of paragraphs and transitions. Ideas universally progress and relate to each other. The writer has been careful to use paragraph and transition construction to guide the reader. Paragraph structure is seamless. Individually and collectively, paragraphs are coherent and cohesive.5.0 %Mechanics of Writing (includes spelling, punctuation, and grammar)No paper was turned in to grade.Writing errors are pervasive enough that they impede communication of meaning.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Frequent and repetitive mechanical errors that distract the reader.Some mechanical errors or typos are present, but are not overly distracting to the reader.Paper is largely free of mechanical errors, although a few may be present.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Writer is clearly in control of standard, written American English.3.0 %Language Use and Audience Awareness (includes sentence construction, word choice, etc.)No paper was turned in to grade.Inappropriate word choice, sentence construction, and/or lack of variety in language use. Writer appears to be unaware of audience. Use of ?primer prose? indicates writer either does not apply figures of speech or uses them inappropriately.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Some distracting and/or inconsistencies in language choice (register), sentence structure, and/or word choice are present. Sentence structure may be occasionally ineffective or inappropriate. The writer exhibits some lack of control in using figures of speech appropriately.Sentence structure is correct and occasionally varies. Language is appropriate to the targeted audience for the most part.The writer is clearly aware of audience; uses a variety of sentence structures and appropriate vocabulary for the target audience; uses figures of speech to communicate clearly.A 22-year-old woman reports being “sick with the flu” for the past 8 days.The writer uses a variety of sentence constructions, figures of speech, and word choice in unique and creative ways that are appropriate to purpose, discipline, and scope.2.0 %Excellent adherence to assignment length criteria (within stated criteria)No paper was turned in to grade.This is not included for this part of the paper.Poor adherence to assignment length criteria (within50% of stated criteria).Weak adherence to assignment length criteria (within 25% of stated criteria).Adequate adherence to assignment length criteria (within 10% of stated criteria).Excellent adherence to assignment length criteria (within stated criteria).5.0 %APA Format A 22-year-old woman reports being “sick with the flu” for the past 8 days. 5.0 %Evaluating and Documenting Sources (includes use of appropriate style, correct citation format in-text and in References section)No paper was turned in to grade.Contains no title page, no References section, and no correctly cited references within the body of the presentation.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Title page is incomplete or inaccurate. References section includes sources, but many citation errors. References within the body of the paper are included, but with many citation errors.Title page has minor errors. References section includes sources, but they are not consistently cited correctly. References included within the body of the paper, but with some citation errors.Title page has minor errors. References section includes sources, but they are not consistently cited correctly. References included within the body of the paper, but with some citation errors.Title page is complete. References section includes correctly cited sources. References within the body of the paper are included and correctly cited.100 %Total Weightage  Bottom of Form   Acid-base disturbance classificationThe patient has metabolic alkalosis that is uncompensated. The patient is not hypoxic or desaturated as the PaO2 and oxygen saturation are within the normal range He is alkalotic because the pH is above the normal limit of 7.45. The bicarbonate levels are also high at 32 meq/liter. It is uncompensated because the PaCO2 is within the normal range. Being a metabolic alkalosis, respiratory compensation is expected where there will be retention of carbon dioxide to levels above 45 mmHg (Fencl et al., 2000).A 22-year-old woman reports being “sick with the flu” for the past 8 days.Factors causing this acid-base disturbanceThe possible factors that led to metabolic alkalosis in this patient include vomiting, dehydration, use of antacids, hypokalemia or renal loss.Vomiting as a cause of metabolic alkalosisThe gastric content has hydrochloric acid. In the real sense, however, the gastric fluid is an extravascular pool whose loss would not affect the hydrogen ion concentration in the intravascular compartment. This phenomenon does not happen because the loss of gastric fluid is shortly followed by secretion of new acid. Inside the cells, the acid dissociates into bicarbonate and hydrogen ions. The proton pump secretes the hydrogen ions into the stomach while the bicarbonate ions go into circulation. Such phenomenon will lead to alkaline tide after feeding. Thus, vomiting will lead to bicarbonate accumulation in circulation as long as there is no concomitant loss of duodenal fluid that is rich in bicarbonate. The accumulation will happen together chloride, potassium and water loss making the patient be dehydrated, hypokalemic and alkalotic.A 22-year-old woman reports being “sick with the flu” for the past 8 days.DehydrationDehydration worsens the alkalosis. It stimulates the reabsorption of sodium through the renal tubules to ensure maximum water retention.  In the proximal tubule, reabsorption of sodium requires concomitant bicarbonate or chloride reabsorption. In the face of loss chloride levels that are caused by vomiting like in this patient, it is the reabsorption of bicarbonate that will increase, despite the high bicarbonate levels.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Dehydration will further stimulate aldosterone secretion. Aldosterone will cause sodium reabsorption in the distal tubules and increase excretion of potassium in the face of low potassium levels and the patient will have paradoxical aciduriaAntacidsIngestion or infusion of alkali will cause metabolic alkalosis. Such is because the antacids will cause a gain in the levels of bicarbonate as they are the primary components of the drug. Citrate and bicarbonate ingestion will have similar effects. Renal and respiratory systems With metabolic alkalosis, there will be renal compensation. Because there are high levels of bicarbonate in circulation, the respiratory system will compensate by retaining carbon dioxide that will lead to increased acid levels to cancel out the effects of the bicarbonate bases. The renal system will compensate through increased renal bicarbonate loss (no retention of bases). (Khanna&Kurtzman, 2006).A 22-year-old woman reports being “sick with the flu” for the past 8 days.Pharmacologic intervention Treatment of metabolic alkalosis involves the management of the underlying cause. In this case, there is need to correct dehydration as it will worsen the alkalosis. Giving normal saline to the patient will correct dehydration and hypochloremia (low chloride levels) that results from vomiting. The cause of vomiting should be identified and treated. Meanwhile giving antiemetic drug like ondansentron will control the vomiting and prevent bicarbonate accumulation and chloride loss. Ondansentron is a serotonin receptor antagonist that blocks the receptors in the gastrointestinal tract and stops nausea and vomiting. If hypokalemia is present, it should be treated with potassium chloride as it will worsen the alkalosis and prevents a further problem of tetany and arrhythmias (Galla, 2000).  There is also the need to stop the injudicious use of antacids.A 22-year-old woman reports being “sick with the flu” for the past 8 days.Educational needs There is need to educate the patient on the symptoms of the flu. It is unlikely that flu cause intractable nausea and vomiting for the past eight days. A diagnostic work up should be carried out. There is also need to educate the patient to seek care quickly fast before symptoms worsen to the extent that she becomes dehydrated and faints. She needs to recognize the sign of dehydration such as drying of the mouth. She needs to drink a lot of fluid to control dehydration that worsens alkalosis. Importantly, she needs to be taught on judicious use of antacids. Antacids do not treat flue and neither do they help much with nausea.A 22-year-old woman reports being “sick with the flu” for the past 8 days.  ReferencesFencl, V., Jabor, A., Kazda, A., &Figge, J. (2000). Diagnosis of metabolic acid–base disturbances in critically ill patients. American journal of respiratory and critical care medicine, 162(6), 2246-2251.Galla, J. H. (2000). Metabolic alkalosis. Journal of the American Society of Nephrology, 11(2), 369-375.Khanna, A., &Kurtzman, N. A. (2006). Metabolic alkalosis. Journal of nephrology, 19, S86-96. A 22-year-old woman reports being “sick with the flu” for the past 8 days.

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