An 89-year-old patient presents with fever

Author: NursingWriter

June 20th, 2018

An 89-year-old patient presents with fever, rigors, hypotension and reduced urine output. They appear confused and are unable to provide any meaningful history. The care home that the patient came from has provided some basic documentation. You look through the information available and note that the district nurse changed this patient’s catheter 24 hours ago. The medical registrar commences antibiotics, aggressive fluid resuscitation and asks you to perform an arterial blood gas, the results of which are shown below. The patient was not on oxygen at the time of the ABG.

PaO2: 12.4 (11-13 kPa)
pH: 7.29 (7.35 – 7.45)
PaCO2: 5.5 (4.7-6.0 kPa)
HCO3-: 15 (22-26 mEg/L)
BE: – 4 (-2 to +2)
WHAT DOES THE ABG SHOW?WHAT IS THE LIKELY DIAGNOSIS, GIVEN THE PATIENT’S HISTORY?HOW HAS THIS ILLNESS LED TO THE ABG DERANGEMENT?

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