A.C. is a 79-year-old man living in a long-term care facility. He has had multiple medical diagnoses, including heart failure (HF), chronic obstructive pulmonary disease (COPD), and a stroke. He is bedridden and receiving enteral tube feedings. He has chronic diarrhea thought to be related to his tube feedings. He receives digoxin and furosemide (Lasix) to manage his heart failure.
1. A.C. is prone to several acid-base and fluid-electrolyte disorders. Which of the following is/are true for this patient? (select all that apply)
a. Hypokalemia
b. Respiratory acidosis
c. Hypernatremia
d. Saline excess
How would A.C. attempt to compensate for respiratory acidosis should it occur? (select all that apply)
a. Compensation through renal excretion of bicarbonate ions.
b. Compensation through renal production of more bicarbonate ions.
c. Compensation through hyperventilation.
d. Compensation through hypoventilation.
3. What acid-base imbalance might occur as a result of A.C.'s chronic diarrhea? (select all that apply)
a. Metabolic alkalosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Respiratory acidosis
Case-2: Patient History
L.S. is brought to the emergency department for management of acute mushroom poisoning. Her respirations are slow and shallow, and she is nonresponsive. She is admitted to the critical care unit to be closely monitored for the development of respiratory failure and renal failure, which often accompany mushroom poisoning. Her urine output is decreased to about 20 ml/hr. Her laboratory values are serum K+ = 5.7 mEq/L; arterial blood gases (ABGs): pH = 7.13, PaCO2 = 56 mm Hg, PaO2 = 89 mm Hg, HCO3- = 18 mEq/L.
Analyze this case study and answer the next four questions that follow.
Case-2 Question-1
What is the most likely cause of L.S.'s potassium imbalance? (select all that apply)
The most likely cause of L.S.'s potassium imbalance is her shallow breathing.
The most likely cause of L.S.'s potassium imbalance is impaired kidney function.
The most likely cause of L.S.'s potassium imbalance is respiratory failure.
The most likely cause of L.S.'s potassium imbalance is renal failure.
