Let's analyze the given arterial blood gas (ABG) values in the context of normal ranges for different parameters.
First, let's list the normal ranges:
- PCO₂ (partial pressure of carbon dioxide): 35-45 mmHg
- HCO₃ (bicarbonate): 22-26 mmol/L
- pH: 7.35-7.45
Given the patient's values:
- PCO₂: 58 mmHg (higher than normal)
- HCO₃: 27 mmol/L (slightly higher than normal)
- pH: 7.3 (lower than normal)
Now, we'll interpret each parameter individually:
1. PCO₂ is significantly elevated at 58 mmHg, which suggests that there is a buildup of carbon dioxide in the blood.
2. HCO₃ is slightly elevated at 27 mmol/L, but this could be a compensatory response and is not significantly outside the normal range.
3. pH is 7.3, which is below the normal range, indicating acidemia (an acidic condition in the blood).
Next, we can combine this information to determine the type of acid-base imbalance:
- The elevated PCO₂ and decreased pH suggest a primary respiratory issue because carbon dioxide is an acid when dissolved in the blood.
- Despite the slight increase in HCO₃, it does not counteract the low pH sufficiently, indicating that the body has not fully compensated for the imbalance.
The condition described by high PCO₂ and low pH is Respiratory Acidosis, a condition where the lungs cannot remove enough CO₂, causing the acid levels in the body to increase and lowering the pH.
Therefore, the acid/base imbalance that is likely the reason the old man could not get up in the morning is Respiratory Acidosis.
