A 50-year-old patient’s pH- 7.05, HCO3=5 PCO2=12, BE=30 mEq/L. How much sodium bicarbonate to be given in first hour?
**Core Concept**
The patient is presenting with severe metabolic acidosis, as indicated by the low pH and low bicarbonate (HCO3) levels. The **base excess (BE)** is also significantly elevated, suggesting a substantial deficit in bicarbonate.
**Why the Correct Answer is Right**
To correct metabolic acidosis, **sodium bicarbonate (NaHCO3)** is often administered. The amount of NaHCO3 to be given can be estimated using the formula: NaHCO3 (mEq) = 0.5 x body weight (kg) x desired increase in HCO3 (mEq/L). However, in severe cases, a more straightforward approach might be applied, considering the base deficit and the patient's volume status.
**Why Each Wrong Option is Incorrect**
**Option A:** This option might underestimate the severity of the acidosis and the required correction.
**Option B:** Similarly, this could be too little for the degree of acidosis presented.
**Option C:** Without the exact details of each option, the general principle is to choose the option that best matches the calculated need based on the base deficit and the clinical scenario.
**Clinical Pearl / High-Yield Fact**
In treating metabolic acidosis, especially when administering **sodium bicarbonate**, it's crucial to monitor the patient's pH, HCO3 levels, and **potassium levels**, as bicarbonate can affect potassium homeostasis, potentially leading to hypokalemia.
**Correct Answer:**