An 85 year old female with bowel obstruction is in your Emergency department for the past 12 hours waiting for a bed. She has been seen by the general surgical team and accepted for admission. She has been having increasing pain and abdominal distension requiring opiate analgesics. The nurse has interrupted you on multiple occasions because the patient is becoming increasingly tired and breathless with some mild confusion. You are slightly annoyed by this and finally decide to see the patient. You find the patient looking unwell, on 4 litres oxygen in you short stay ward. You decide to move the patient to the resuscitation area and do “blood tests”

Her ABG shows:pH  7.43

pCO2  65 mmHg

pO2  67 mmHg

HCO3  43

BE  15

O2 sats  92%

Lactate  2.7 mmol/l

Na  131 mmol/l

K  4.4  mmol/l

Cl  78 mmol/l

Creat  130 umol/l

Urea  14.5 mmol/l

Glu  11.6 mmol/l

Describe your assessment of this patient

Describe the abnormalities on blood tests and interpret them