Question

A.C. is a 79-year-old man living in a long-term care facility. He has had multiple medical diagnoses, including heart failure (HF), chronic obstructive pulmonary disease (COPD), and a stroke. He is bedridden and receiving enteral tube feedings. He has chronic diarrhea thought to be related to his tube feedings. He receives digoxin and furosemide (Lasix) to manage his heart failure.

1. A.C. is prone to several acid-base and fluid-electrolyte disorders. Which of the following is/are true for this patient? (select all that apply)

a. Hypokalemia
b. Respiratory acidosis
c. Hypernatremia
d. Saline excess

2. How would A.C. attempt to compensate for respiratory acidosis should it occur? (select all that apply)a. Compensation through renal excretion of bicarbonate ions.b. Compensation through renal production of more bicarbonate ions.c. Compensation through hyperventilation.d.Compensation through hypoventilation.
3. What acid-base imbalance might occur as a result of A.C.’s chronic diarrhea? (select all that apply)a. Metabolic alkalosisb. Respiratory alkalosisc. Metabolic acidosisd. Respiratory acidosis

Answer 1

1.

b. Respiratory acidosis

2.

b. Compensation through renal production of more bicarbonate ions.

c. Compensation through hyperventilation.

3.

a. Metabolic alkalosis

Step-by-step explanation:

Hello!

Remember when talking about acid-base disorders you can find 4 different situations.

If you take the changes in bloods pH into account you can categorize the acid-base disorders as:

If the pH of the blood decreases, then the patient suffers from acidosis.

If the ph of the blood increases, then the patient suffers from alkalosis.

Depending on wich regulatory system is affected (Respiratory system or Renal system) you can categorize the acid-base disorders as:

Respiratory: For patological or not patological reasons the respiratory system isn't effectively removing CO₂ from blood.

Metablolic: Due to a sickness the renal system isn't regulating the equilibrium efficiently or the body is going trough a normal proccess that modifies the blood's pH (For example after strong excersise the musless release lactic acid, decreasing the pH and creating a momentary state of metebolic acidosis or after eating due to the production of HCL in the stomach a large amount of HCO₂⁻ is released to circulation, increasing the pH and causing a metabolic alkalosis state.)

1.

Due to the chronic obstructive pulmonary disease is expectet that the patient pulmonary gas exchange would not be efficient. This ineffective gas exchange lead to an increase of the blood concentration of CO₂. When the blood levels of CO₂ increase, the pH of the blood decreases and the patient will exhibit Respiratory acidosis.

K⁺ and Na⁺ are related to disorders in the acid-base equilibrium. When pH decreases the Na⁺/K⁺ and the cotransporter Na⁺, K⁺, Cl⁻reduce teir activity, i.e. K⁺ is no longer transported into the cells. This produces an increase on the K⁺ blood concentrarions (Hyperkalemia) and since there is no transporter taking the Na⁺ out of the cellsl its concentration levels in blood wil decrease (Hyponatremia)

2.

To compensate the respiratory acidosis the renal system increases the excretion of H⁺ and increases the retenrion of HCO₃⁻. The body will also increase the blood flux to the pulmonary system and alveolar ventilation by increasing the heart rate.

3.

Chronic diarrhea causes deshidratation and is a extreme lose of water with electrolies, ingluding the HCO₃⁻.

This means that the chronic diharrea add to the disorter., this causes metabolic alkalosis.

I fope it helps