Scenario
Tony is a 56-year-old, African-American male with a history of sickle cell disease, hypertension, and CKD stage 4 was seen in the renal clinic. His kidney function has been declining over the last decade, but has been stable over the last two years. He states “I haven’t felt good for about a week, but couldn’t afford to miss work.” He complains of a not wanting to eat, fast heartbeat, and feeling exhausted. Upon physical examination, you notice that Tony is having long, deep breaths his respiratory rate is 25 breaths per minute and labored, heart rate 115 beats per minute, blood pressure 132/71 mm Hg, and his pulse oximetry is 91% on room air. You notify the MD. He orders oxygen at 2 L via NC, IV fluids, and an arterial blood gas.

Tony’s ABG results:
pH 7.3
PaCO2 – 31 mm Hg
PaO2 – 80 mm Hg
HCO3 – 18 mEq/L

Instructions
In a 1-2 page Word document:
1. Determine Tony’s acid-base imbalance
2. Describe possible causes of the imbalance
3. Identify the signs and symptoms that Tony is exhibiting as a result of the acid-base imbalance
4. List the multidimensional care strategies that are appropriate for the care of Tony