Question

Student Handout for Case Study: Diabetes Directions Read the following case study and answer each of the questions, Daryl is an 18-year-old male, who was diagnosed with type 1 diabetes 10 years ago. He is brought to the emergency department by his parents. Daryl seems anxious and confused. He is pale and hyperventilating. He has a racing heart rate and hypotension. Blood glucose measurements indicate a serum glucose of 350 mg/dL Daryl explains that he ate 'some junk food with friends and forgot to take his insulin. Arterial blood gases are as follows: pH=7.25 PaO= 100 mm Hg PaCO2= 22 mm Hg Serum values reveal hyperkalemia, reduced bicarbonate, and acetone. 1. What acid-base abnormality does Daryl display? 2. Why is Daryl's PCO2 value lower than normal? 3. Why is Daryl hyperventilating? 4. Why is Daryl's serum bicarbonate reduced? 5. Why is Daryl experiencing hyperkalemia? 6. What is the significance of the presence of acetone in the serum samplo? 7. What medical intervention may help Daryl's condition?

Answer 1

1) Because pH is 7.25, the condition is acidosis as the blood is outside the normal range of 7.35 to 7.45.

2) PCO₂ value of Daryl is lower than normal because of hyperventilation to compensate for the acidosis. in case of hyperventilation, patients cause a larger elimination of CO2 from the lungs.

3) Daryl is hyperventilating in order to compensate for the excess hydrogen ions.

4) Daryl's serum bicarbonate is reduced because of the excess binding of hydrogen to the bicarbonate, which diminishes the bicarbonate.