A 32 year old Aboriginal woman presents to the ED with lethargy. She is previously well, and has not been seen by medical services for the previous 10 years.

Her VBG reveals:

pH 7.25

pCO2 24.4

HCO3 11.7

Hb 81

Na 140

K 5.1

Ca++ 0.81

Cl 98

Gluc 9.6

Lact 0.9

Questions:

1.What is the most likely cause for this VBG?

Describe and interpret the abnormalities

2.Her Creatinine is 1842 with a urea of 62

List 4 causes for these findings in a 32 year old Aboriginal woman, with the most common causes first.

3.What are the principles of management?

4.She becomes agitated and appears to be getting ready to leave the ED. What would be some strategies to stop her leaving?

5.Describe cultural competency in health practice.