Focused Assessment Name Institution Instructor Course Date Focused Assessment Focused History The case study provided involves a 22-year old woman suffering from flu for the last 8 days

April 13, 2019 Critical Thinking

Focused Assessment
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Focused Assessment
Focused History
The case study provided involves a 22-year old woman suffering from flu for the last 8 days. Other symptoms reported include vomiting which happens several times in a day, problems in keeping food and other liquids (Ashelford, Raynsford, & Taylor, 2016). The patient has also been using more than the required doses of antacids to help her in relieving her nausea which have resulted to dehydration (Ashelford, Raynsford, & Taylor, 2016). The patient is also reported to have fainted while at home where she was taken to a local healthcare facility. At the healthcare facility, an IV was placed to help her dehydration problems and tests were conducted on the patient’s arterial blood gas, which gave out results indicated in the case study (Ashelford, Raynsford, ; Taylor, 2016).
Classification of the Patient’s Acid Base Disturbance
The results of the patient’s arterial blood gas indicated in the case study show a pH of 7.5, which is a high level, and this means that the patient is in a metabolic alkalosis. The normal pH level is 7.35 and 7.45 for arterial blood (Ashelford, Raynsford, ; Taylor, 2016). This has been because of too many bases, which have been attributed to the large amounts of antacids taken by the patient. This has led to increased levels of bicarbonate in the blood of the patient. The HCO3, which is the bicarbonate level, is higher at 32 meq/liter. This is further evidence pointing to metabolic alkalosis (Ashelford, Raynsford, ; Taylor, 2016). The patient has an excess in bases. The acid-base levels are measured through a pH test where increased acid levels will result to the fall of the pH levels while increase in base levels will result in a rise in the pH levels, as is the case in the case study. The carbon dioxide pressure, oxygen saturation, and the amount of oxygen to hemoglobin in arterial blood are within the normal range (Ashelford, Raynsford, ; Taylor, 2016).

How Would The Renal And Respiratory Systems Try To Compensate For This Acid-Base Disturbance?
The acid-base balance involves having the right balance of basic and acidic compounds in the blood to enable the blood to function effectively (Logan ; Micalos, 2015). The lungs and kidneys carry out this function to ensure a proper balance between the acid and base levels as differences in the normal levels could affect certain body organs (Logan ; Micalos, 2015). The kidneys maintain blood pH by controlling the amount of bicarbonate. If the bicarbonate levels are high, the kidneys excrete the excess base. The lungs compensate for the metabolic alkalosis by retaining the carbon dioxide, which is used in the formation of carbonic acid to bring the pH to normal levels (Logan ; Micalos, 2015).
Possible Factors Causing This Acid-Base Disturbance
The normal arterial blood pH should be in the range of 7.35 to 7.45. Any patient having a lower pH level than the normal range is reported to be in acidosis where else a patient having a higher pH than the normal range is reported to be in alkalosis (Logan ; Micalos, 2015). In this case, the patient has a higher pH level indicating a metabolic alkalosis condition, which has caused the acid-base disturbance (Logan ; Micalos, 2015). Possible factors causing this acid-base disturbance include the large amounts of antacids, which the patient has been taking. Antacids contain chemicals, which are bases and can be used to decrease the acid level if the pH levels decreases to a low level. This has led to an increased bicarbonate level from the normal level of 22 to 26 32 meq/litre to a level of 32 meq/litre (Logan ; Micalos, 2015).

What Pharmacologic Intervention Is Commonly Used To Correct This Acid-Base Disturbance
Pharmacologic Intervention involves addressing the underlying causes, which include rehydration to enable effective functioning of the kidneys, which are important in effectively maintaining the normal pH levels (Ashelford, Raynsford, ; Taylor, 2016). Medications to decrease the bicarbonate levels and address the vomiting should also be given. Antiemetics are used to control the vomiting. The patient should also use the recommended dose of antacids, as they are reason behind the alkalosis (Ashelford, Raynsford, ; Taylor, 2016). Healthcare professionals may use a low bicarbonate dialysate to lower the bicarbonate levels.
Similarities and Differences between Focused Assessment and a Complete Assessment
Complete assessments include the patient history, general appearance, and physical examination where else focuses assessment include a detailed assessment of specific body systems relating to the presenting concern of the patient (Ashelford, Raynsford, ; Taylor, 2016). Comprehensive assessment involved an analysis of the presenting issues of the patient, which included the flu, frequent vomits, and dehydration. Focused assessment included the drawing of arterial blood gas, which revealed more information regarding the concern (Ashelford, Raynsford, ; Taylor, 2016).
The comprehensive is very broad where else the focuses assessment focuses on a particular body system. The focused assessment focused on the arterial blood gas analysis where else the comprehensive assessment focused on the general body systems (Ashelford, Raynsford, ; Taylor, 2016). This included high levels of bicarbonate levels and an increased pH level. Similarities include the analysis by a professional healthcare. The comprehensive assessment directs the focused assessment. Both assessments are used to address the presenting problem (Ashelford, Raynsford, ; Taylor, 2016).

References
Ashelford, S., Raynsford, J., ; Taylor, V. (2016). Pathophysiology and Pharmacology for Nursing Students. London: Learning Matters.

Logan, P., ; Micalos, P. (2015). Pathophysiology and Pharmacology 1: BMS291. Chatswood, N.S.W.: Elsevier Australia.