Clinical scenerios

1. Gossip, an undergraduate, has normal PCO2 levels, high H+ levels, low pH and bicarbonate levels. What type of disturbance is Gossip suffering from and what might cause this? If his PCO2 were elevated, would your answer change? Explain.

2. Diabetes mellitus produces many homeostatic imbalances, including acidosis. The pH imbalance is due to ketoacidosis, which results from excessive accumulation of byproducts of fat metabolism, as the body cannot meet energy needs from carbohydrate metabolism. Sally is a teenaged diabetic who sometimes rebels by not taking her insulin. Her mother takes her to the hospital because her breathing has become deep and gasping. Explain Sally’s breathing pattern. What other compensatory responses may occur and would they occur earlier or later than the respiratory response?

3. Mary, a nursing student, has been caring for burn patients. She notices that they consistently show elevated levels of potassium in their urine and wonders why. What would you tell her?

4. Why does potassium concentration rise in patients with acidosis? What is this called? What effects does it have?

5. Burn patients have damaged skin cells that are unable to prevent water loss. The kidneys help retain water by using the sodium-potassium pump. It pumps more sodium into the cells so that water can follow the movement of sodium and can be reabsorbed. Sodium ions are exchanged with potassium being pumped out of the cells into the renal tubules, where it’s secreted in urine. Therefore, potassium levels in urine are high.

6. Acidosis can affect the amount of potassium in a patient’s blood serum, causing it to become unusually high or low. Patients develop acidosis when the acid and base balance of the body is disrupted because the lungs or kidneys are not functioning properly. Some forms cause potassium to rise in the blood serum. This occurs because of a net movement from cells to the bloodstream in an attempt to maintain stable pH, which is called hyperkalemia. Hyperkalemia symptoms may include muscle paralysis, pyspnea, palpitations, chest pain, also nausea and/or vomiting.