Ch. 26 Fluid, Electrolyte, and Acid-Base Balance
Chapter 25, Problem 22
Explain how emphysema and congestive heart failure can lead to acid-base imbalance.
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Related Practice
Textbook Question
Explain the relationship of the following to renal secretion and excretion of hydrogen ions:
a. plasma carbon dioxide levels,
b. phosphate, and
c. sodium bicarbonate reabsorption.
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Textbook Question
Mr. Jessup, a 55-year-old man, is operated on for a cerebral tumor. About a month later, he appears at his physician's office complaining of excessive thirst. He claims to have been drinking about 20 liters of water daily for the past week and says he has been voiding nearly continuously. A urine sample is collected and its specific gravity is reported as 1.001. What is your diagnosis of Mr. Jessup's problem? What connection might exist between his previous surgery and his present problem?
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Textbook Question
For each of the following sets of blood values, name the acid-base imbalance (acidosis or alkalosis), determine its cause (metabolic or respiratory), decide whether the condition is being compensated, and cite at least one possible cause of the imbalance.
Problem 1: pH 7.63; Pco₂ 19 mm Hg; Hco₃⁻ 19.5 mEq/L
Problem 2: pH 7.22; Pco₂ 30 mm Hg; Hco₃⁻ 12.0 mEq/L
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Textbook Question
Mrs. Bush, a 70-year-old woman, is admitted to the hospital. Her history states that she has been suffering from diarrhea for three weeks. On admission, she complains of severe fatigue and muscle weakness. A blood chemistry study yields the following information: Na⁺ 142 mEq/L; K⁺ 1.5 mEq/L; Cl ⁻ 92 mEq/L; Pco₂ 32 mm Hg. Which electrolytes are within normal limits? Which are so abnormal that the patient has a medical emergency? Which of the following represents the greatest danger to Mrs. Bush?
a. a fall due to her muscular weakness,
b. edema,
c. cardiac arrhythmia and cardiac arrest.
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Textbook Question
During a routine medical checkup, Shelby, a 26-year-old physiotherapy student, is surprised to hear that her blood pressure is 180/110. She also has a rumbling systolic and diastolic abdominal bruit (murmur) that is loudest at the mid-epigastric area. Her physician suspects renal artery stenosis (narrowing). She orders an abdominal ultrasound and renal artery arteriography, which confirm that Shelby has a small right kidney and the distal part of her right renal artery is narrowed by more than 70%. Her physician prescribes diuretics and calcium channel blockers as temporary measures, and refers Shelby to a cardiovascular surgeon. Explain the connection between Shelby's renal artery stenosis and her hypertension. Why is her right kidney smaller than her left? What would you expect Shelby's blood levels of K⁺, Na⁺, aldosterone, angiotensin II, and renin to be?
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