A 55 year old female presents to ypur ED with an altered mental state.

Her VBG is as follows:

pH  7.54    (7.36-7.44)

pCO2   48    (35-45 mmHg)

pO2  31

HCO3  41   (24 +/- mmol/l)

BE  16

Na  100    (137-145 mmol/l)

K   2.1   (35-5 mmol/l)

CL  53   (99-111  mmol/l)

Glucose  5.6

Lactate  3.3

1. Describe and interpret the VBG

2. What are the likely reasons for her altered mental state

3. How would you treat her?