PLEASE DO NOT COPY OFF OF OTHER answers ANSWERS OR GOOGLE ANSWERS THXs Case Study Vomiting Mr. K.B. is age 81 and has had
Posted: Thu Mar 31, 2022 8:02 am
PLEASE DO NOT COPY OFF OF OTHER answers ANSWERS OR GOOGLE
ANSWERS THXs
Case Study Vomiting
Mr. K.B. is age 81 and has had gastritis with severe vomiting
for 3 days. He has a history of heart problems and is presently
feeling dizzy and lethargic. His eyes appear sunken, his mouth is
dry, he walks unsteadily, and he complains of muscle aching,
particularly in the abdomen. He is thirsty but is unable to retain
food or fluid. A neighbor has brought Mr. K.B. to the hospital,
where examination shows that his blood pressure is low, and his
pulse and respirations are rapid. Laboratory tests demonstrate
elevated hematocrit, hypernatremia, decreased serum bicarbonate,
serum pH 7.35, and urine of high specific gravity (highly
concentrated).
This case study illustrates a combination of fluid, electrolyte,
and acid-base imbalances. Specific laboratory values are not given
so as to focus on the basic concepts. For clarity, this case study
is discussed in three parts, the early stage, middle stage, and
advanced stage of the imbalances. Further information about the
specific problems involved is given in each part and is followed by
a series of questions.
Part A: Day 1
Initially, Mr. K.B. lost water, sodium in the mucus content, and
hydrogen and chloride ions in the hydrochloric acid portion of the
gastric secretions.
Alkalosis develops for two reasons, the first being the direct
loss of hydrogen ions and the second being the effects of chloride
ion loss. When chloride ion is lost in the gastric secretions, it
is replaced by chloride from the serum. To maintain equal numbers
of cations and anions in the serum, chloride ion and bicarbonate
ion can exchange places when needed. Therefore, more bicarbonate
ions shift into the serum from storage sites in the erythrocytes to
replace the lost chloride ions. More bicarbonate ions in the serum
raise serum pH, and the result is “hypochloremic alkalosis.”
Part B: Days 2 to 3
As Mr. K.B. continues to vomit and is still unable to eat or
drink any significant amounts, loss of the duodenal contents, which
include intestinal, pancreatic, and biliary secretions, occurs. No
digestion and absorption of any nutrients occurs.
Losses at this stage include water, sodium ions, potassium ions,
and bicarbonate ions. Also, intake of glucose and other nutrients
is minimal. Mr. K.B. shows elevated serum sodium levels.
ANSWERS THXs
Case Study Vomiting
Mr. K.B. is age 81 and has had gastritis with severe vomiting
for 3 days. He has a history of heart problems and is presently
feeling dizzy and lethargic. His eyes appear sunken, his mouth is
dry, he walks unsteadily, and he complains of muscle aching,
particularly in the abdomen. He is thirsty but is unable to retain
food or fluid. A neighbor has brought Mr. K.B. to the hospital,
where examination shows that his blood pressure is low, and his
pulse and respirations are rapid. Laboratory tests demonstrate
elevated hematocrit, hypernatremia, decreased serum bicarbonate,
serum pH 7.35, and urine of high specific gravity (highly
concentrated).
This case study illustrates a combination of fluid, electrolyte,
and acid-base imbalances. Specific laboratory values are not given
so as to focus on the basic concepts. For clarity, this case study
is discussed in three parts, the early stage, middle stage, and
advanced stage of the imbalances. Further information about the
specific problems involved is given in each part and is followed by
a series of questions.
Part A: Day 1
Initially, Mr. K.B. lost water, sodium in the mucus content, and
hydrogen and chloride ions in the hydrochloric acid portion of the
gastric secretions.
Alkalosis develops for two reasons, the first being the direct
loss of hydrogen ions and the second being the effects of chloride
ion loss. When chloride ion is lost in the gastric secretions, it
is replaced by chloride from the serum. To maintain equal numbers
of cations and anions in the serum, chloride ion and bicarbonate
ion can exchange places when needed. Therefore, more bicarbonate
ions shift into the serum from storage sites in the erythrocytes to
replace the lost chloride ions. More bicarbonate ions in the serum
raise serum pH, and the result is “hypochloremic alkalosis.”
Part B: Days 2 to 3
As Mr. K.B. continues to vomit and is still unable to eat or
drink any significant amounts, loss of the duodenal contents, which
include intestinal, pancreatic, and biliary secretions, occurs. No
digestion and absorption of any nutrients occurs.
Losses at this stage include water, sodium ions, potassium ions,
and bicarbonate ions. Also, intake of glucose and other nutrients
is minimal. Mr. K.B. shows elevated serum sodium levels.