Acid base imbalance

CompetencyDescribe strategies for safe, effective multidimensional nursing care for clients with acid-base imbalances.ScenarioTony is a 56-year-old, Hispanic male that presented to the Emergency Room with complaints of frequent, which he has been experiencing for the past four days. He states “I haven’t felt good for about a week, but couldn’t afford to miss work.” He complains of diarrhea, lightheadedness, and feeling exhausted. Past medical history includes asthma and chronic obstructive pulmonary disease. Upon physical examination, you notice that Tony is pale, drowsy, and his respiratory rate is 28 breaths per minute and deep, heart rate 125 beats per minute, blood pressure 80/40 mm Hg, and pulse oximetry is 90% on room air. You notify the MD. He orders oxygen at 2 L via NC, a guaiac stool, and arterial blood gas.Tony’s ABG results:pH 7.28PaCO2 – 32 mm HgPaO2 – 70 mm HgHCO3 – 18 mEq/LInstructionsIn a–2-page Word document:Determine      Tony’s acid-base imbalanceDescribe      possible causes of the imbalanceIdentify      the signs and symptoms that Tony is exhibiting as a result of the      acid-base imbalanceList      the multidimensional care strategies that are appropriate for the care of      Tony