mechanism how vomiting could cause disorder?
M.C. is 20 y. old philosophy major at state university. when the 24 hour stomach flu went around campus, she was one of the first students to become ill. however, instead of 24 hours, she vomited for 3 days. during that time, she was unable to keep anything down, and she sucked on ice chips to relieve her thirst. by the time she was seen in student health center, the vomiting had stopped, but she could barely hold her head up. On physical examination, her blood pressure was 100/60 and she had decreased skin turgor and dry mucous membranes. a blood sample yielded the following results: arterial: pH=7.53, HCO3=37mEq/L, pCO2=49mm Hg, Venous: Na=137 mEq/L, Cl=82 mEq/L, K2.8 mEq/L. She was admitted to college infirmary , where she received an infusion of isotonic saline and potassium. She was released the next day after her fluid and electrolyte status returned to normal.
QUESTIONS:
1) What acid-base disorder did M.C have after vomiting for three days? explain fully
2) Propose a mechanism for how vomiting could cause disorder.
3) Compared with an individual with normal blood values, would you expect M.C.’s breathing rate to be increased, decreased, or the same? explain.
4) why was her blood pressure decreased? why did she have decreased skin turgor and dry mucous membranes?
5) why did M.C. exhibit decreased K and Cl concentrations? identify mechanism that may have contributed to her hypokalemia.
6) what effect would her decreased blood pressure be expected to have on the reninangiotensin-aldosterone system? explain
Filed under: Potassium and Being Sick
Like this post? Subscribe to my RSS feed and get loads more!
1. Acute metabolic Alkalosis. Caused from the loss of fluids the ratio of what to sodium bicarb increases. And also your body is loosing K a buffer in response your kidneys excreate more HCO3 to normalize this loss Like if you boiled salt water the water would became more salty due to less water.
2 Vomiting would cause this because of the dehydration
3. Book wise you would expect it to slow to normalize pH by by increasing CO2 and in this case she is breathing slower/ shallower due to higher CO2. But this is rare clinically and you don’t see it happen so in this case this has been an on going issue hence the 3 days of vomiting
4. the decreased BP was due to the increased fluid loss. Less volume causes lower pressures. If you had a water balloon the less water in it the less pressure on the balloon walls. Your skin and mucous membranes require water to be flexible and moist. Your body will pull water from surrounding tissues due to the higher salt concentration in your blood, same as in the answer to number 1
5. The decreased K and Cl are due to the decrease in stomach fluids
6 is beyond my area of explaining learned it once couldnt repeat it simply sorry so this page might help it talks about vomiting specifically
http://books.google.com/books?id=57RQC-3OPtUC&pg=PT683&lpg=PT683&dq=decreases+K+due+to+vomiting&source=bl&ots=m7PrQZMnH1&sig=4gXqGu6WEjpgP75UotzHPzKlx7E&hl=en&ei=lQGoSdK6DYTFnQfWjLzwDw&sa=X&oi=book_result&resnum=1&ct=result#PPT686,M1