An overweight 55-year-old single woman from a rural farming…
An overweight 55-year-old single woman from a rural farming area was brought to the emergency department by her neighbor. The woman had a large abscess on the bottom of her foot; she was irritable and complained of blurred vision and of being thirsty. Her breathing was rapid. The neighbor said that the only medication the woman was using was for blood pressure and sometimes an aspirin. Blood and urine samples were collected. Arterial blood gas results were: pH 7.2; PCO2 45 mm Hg; HCO3- 8 mmol/L. Blood glucose was 340 mg/dL and a high anion gap was calculated. Urine glucose and ketones were markedly increased. Based on the laboratory values, what state of acid-base balance is this patient in?