Abnormal Laboratory Findings: Acid-Base and Electrolyte Case Study
Question 1
The abnormal findings in the laboratory results are sodium 147mEq/l because the normal sodium levels are between 135-145mEq/L, arterial blood gases that are pH 7.33 because the normal pH levels are between 7.35-7.45, pCO2 34mmHg because the normal PCO2 level is between 35-45 and urine specific gravity of 1.040 because the normal urine specific gravity is between 1.002-1.030.
Question 2
The specific electrolyte disturbance that the patient is undergoing is hypernatremia that is increased levels of sodium in the blood. This is because according to (McLeod, 2016), the sodium levels in the blood is above the normal range that is 135-145mEq/L. Hypernatremia is caused by conditions such as vomiting and diarrhea, which leads to dehydration of the body. Besides, diseases such as diabetes and drugs such as steroids and hyperventilation cause hypernatremia.
Question 3
Hypernatremia present in various ways. At first, the patient may become asymptomatic until their blood sodium gets exceptionally high. Some of the symptoms include dizziness when standing, diarrhea, vomiting, severe sweating, fever, thirst, headache, confusion, seizures and in a critical situation, the patient may get into a coma (Qian, 2019).
Question 4
In case the patient had hyperkalemia, the patient would have a tall peaked T wave when the patient is assessed using an electrocardiogram. According to (Weiss, Qu & Shivkumar, 2017) the QRS complex becomes widened, the PR waves becomes prolonged, and P waves become flat when assessed using an ECG. Other symptoms include decreased reflexes, muscle relaxation, and arrhythmias.
Question 5
Blood gases changes observed in the patient is metabolic acidosis because the patient has low pH of 7.33 while the normal pH is between 7.35-7.45 and low PaCO2 of 34 while the normal between 35-45 and the HCO3 levels are high since the normal levels are between 22-26 mEq/l (McLeod, 2016).
Question 6
The body uses three mechanisms to regulate pH levels. Chemical buffer is one of the mechanism, and bicarbonate is one of the essential buffers. Bicarbonate reacts with strong acids and bases and produces carbon dioxide and water. Proteins and phosphates are other chemical regulation mechanisms in the body. The proteins and phosphates are mainly intracellular (McLeod, 2016). The second means in which the body regulates the pH is with the respiratory system. The respiratory system acts as a compensatory mechanism for metabolic acidosis and alkalosis. Hyperventilation of the patient helps in regulating metabolic acidosis. The third mechanism is with the renal system. The renal system takes a longer time to act up to one week. The renal system acts as a compensatory mechanism to respiratory alkalosis or acidosis by excreting high amounts of acids during respiratory acidosis and by reducing the excretion of acids during respiratory alkalosis.
References
McLeod, A. (2016). Arterial Blood Gas Analysis-Making it Easy. M&K Update Ltd.
Qian, Q. (2019). Hypernatremia. Clinical Journal of the American Society of Nephrology, 14(3), 432-434.
Weiss, J. N., Qu, Z., & Shivkumar, K. (2017). Electrophysiology of hypokalemia and hyperkalemia. Circulation: Arrhythmia and Electrophysiology, 10(3), e004667.
