Discussion 1
Assessment Descriiption
1. Explain how acid-base physiology leads to the regulation of fluid balance and extra cellular pH.
2. What is the equation for the carbonic acid/bicarbonate buffering system? How do actions at the lungs and kidneys affect this equation and thus compensate for alterations in plasma pH levels?
3. How do changes in plasma osmolality affect the physiology of erythrocytes?
Discussion 2
Scenario
A 75-year-old man was admitted with shortness of breath and lower extremity edema. He has been unwell for about a week and had multiple bouts of diarrhea over the previous 5 days. He does not take any medications. He was hyperventilating and was very distressed when EMS arrived. Admission arterial blood gas is listed below. He was on high concentration oxygen by mask on arrival to the emergency department.
Chemistry Results
Na+ = 127
HCO3- 20
HCO- = 30meq/L 3
K+ = 5.2
BUN 50.5
Glucose 9.5 mmols/l
Cl- 79
Creatinine 0.38
Anion gap 33 mmols/l
Arterial Blood Gases
pH 7.58
pCO2 21 mmHg
pO2 154 mmHg
HCO3 19 mmol/l
Questions
Answer the following questions:
(Respiratory alkalosis, partially compensated.) ROME (PH is high(alkalosis), pCO2 is low(alkalosis), HCO3 is low(acidosis). Remember: ROME for identifying if its respiratory of metabolic.
1. What is this patient’s acid-base disorder?
2. Discuss why you how you came to that conclusion.
Is the patient compensating?
3. What are the pathophysiological responses that the body is attempting to use to compensate?
