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A patient is septic from an acute Clostridium difficile infection and produces a higher than normal amount of lactic acid. Which of the following is MOST likely to occur?

Explanation

•Metabolic acidosis, from the formation of lactic acid, is common during sepsis.

Respiratory Acidosis:
•Respiratory system is the cause, ex. hypoventilation.
•Increase in PCO2, decrease in pH
•Compensation - Kidneys reabsorb Bicarb (HCO3)

Metabolic Acidosis:
•Caused by loss of bicarb or build up of acids, ex. lactic acidosis, diarrhea, renal failure, ketones, ammonium intoxication. Not caused by respiration.
•HCO3 decreases, pH decreases
•Compensation- hyperventilation to eliminate CO2

Respiratory Alkalosis:
•Caused by excessive ventilation
•Decrease in PCO2, increase in pH
•Compensation - Kidneys excrete HCO3

Metabolic Alkalosis
•Acid (H+) loss from emesis, diuretics. Or retention of HCO3 from medications, hyperaldosteronism
•Increase in HCO3, Increase in pH
•Compensation - Respiratory centers are not stimulated, this leads to hypoventilation and CO2 retention

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