have more serious onl Hilll! effects Part C: Day 3: Admission to the Hospital Af
ID: 90356 • Letter: H
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have more serious onl Hilll! effects Part C: Day 3: Admission to the Hospital After a prolonged period of vomiting, metabolic acidosis devel- ops. This change results from a number of factors: Loss of bicarbonate ions in duodenal secretions Lack of nutrients leading to catabolism of stored fats and protein with production of excessive amounts of ketoacids Dehydration and decreased blood volume leading to decreased excretion of acids by the kidney Decreased blood volume leading to decreased tissue perfusion, oxygen to and increased anaerobic metabolism with increased lactic acid Increased muscle activity and stress leading to increased metabolic acid productionExplanation / Answer
1. Mr.K.B.. is lethargic and weak due to continuous and prolonged vomiting. This had led to the loss of fluid and electrolytes in the body leading to the increased acid production. A condition called metabolic acidosis.
2. The serum level of CO2 or carbonic acids in this case is predicted to be low.
Total CO2 level in the serum includes serum bicarbonate and all the available form of CO2 and carbonic acid. Metabolic acidosis leads to the decreased CO2 level.
3. Metabolic acidosis is a condition chracterised by excessive quantities of acid. This occurs when the kidney is unable to remove enough acid from the body. If the condition continues, the pH of blood becomes low (les than 7.35) as a result of increased production of H+ ions by the body or the body's inability to form bicarbonate in the kidney
4. Signs observed when the serum pH falls include rapid and shallow breathing, fatigue, headache accompanied by dehydration.
5. Rise in potassium level occurs in metabolic acidosis. Acid secretion in kidney is usually influenced by serum potassium level. Due to acidosis, potassium moves from cells to extracellular fliud in exchange of H+ ions, a condition caled hyperakalemia. The alteration in acid base balance affects the potassium metabolism. It is also reported that acidosis decreases the potassium secretion in the distal renal tubule directly by affecting the potassium secretory channels and this indirectly increases the level of ammonium production.
6. Replacement fliud therapy to patients diagonised with metabolic acidosis with sodium bicarbonate and potassium citrate along with water is required to replace the lost sodium and potassium due to renal acidosis and to regain the fluidity of the blood.
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