75 year old male with a back ground of metastatic prostate cancer, presents with marked shortness of breath.

Vitals: Sats 90% FiO2 0.4 BP 95/45 HR 110 Temp 37.5 C RR28 CXR shows patchy opacification throughout both lung fields and multiple boney mets.

ABG:

pH 7.2                                 Na 135mmol/l

pCO2 20 mmHg                K 4 mmol/l

pO2 60 mmHg                   Cl 103mmol/l

HCO3 13 mmol/l              Lactate 7mmol/l

B/E -9                                  Hb 58 g/l

1. Describe and interpret the ABG
2. What essential elements does a patient need to demonstrate competence in ceiling of care, or end of life care discussion?