26. Fluid and Electrolyte Balance, Acid Base Balance

Differentiate between respiratory compensation and renal compensation.

Mark the following statements as true or false. If a statement is false, correct it to make a true statement.

b. Renal compensation for acid-base disturbances begins within minutes, whereas respiratory compensation begins within several hours.

After falling into an abandoned stone quarry filled with water and nearly drowning, a young boy is rescued. In assessing his condition, rescuers find that his body fluids have high PCO₂ and lactate levels and low PO₂ levels. Identify the underlying problem and recommend the necessary treatment to restore homeostatic conditions.

Mark the following statements as true or false. If a statement is false, correct it to make a true statement.

e. You would expect to find an elevated Pco₂ in arterial blood gas analysis of a patient with respiratory acidosis.

A laboratory printout of arterial blood gases indicates that a patient has an increased Pco₂ , decreased pH, and normal bicarbonate ion concentration. Is this patient in acidosis or alkalosis? Is the pH disturbance respiratory or metabolic in nature? Explain your reasoning. How long do you think the patient has had this pH disturbance? (Hint: Look at the bicarbonate ion concentration. What system controls the concentration of bicarbonate ions, and how quickly does it compensate for pH disturbances?)

In an individual with metabolic acidosis, a clue that the respiratory system is compensating is provided by:

a. High blood bicarbonate levels

b. Low blood bicarbonate levels

c. Rapid, deep breathing

d. Slow, shallow breathing

The drug Diamox is sometimes used to treat mountain sickness. Diamox inhibits the action of carbonic anhydrase in the proximal convoluted tubule. Polyuria (excessive urine production resulting in frequent urination) is a side effect associated with the medication. Why does polyuria occur?

Explain how the chemical buffer systems resist changes in pH.

The most recent advice from medical and nutritional experts is to monitor one’s intake of salt so that it does not exceed the amount needed to maintain a constant ECF volume. What effect does excessive salt ingestion have on blood pressure?

Ms. Johanssen is a patient in the hospital. The nurse examines her laboratory reports and notices that she has developed hyperkalemia and acidosis over the past several days. On closer examination of her medical chart, the nurse also sees that her physician recently doubled her dose of spironolactone, an aldosterone-blocking diuretic. How does this explain her laboratory findings?

Metabolic alkalosis occurs when:

(a) Bicarbonate ion concentrations become elevated

(b) A severe bicarbonate loss occurs

(c) The kidneys fail to excrete hydrogen ions

(d) Ketone bodies are generated in abnormally large quantities