Case Study #1 on Mrs. X NURS 5315 PDF

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5315 UTA - Patho Case Study assignment 1 - Mrs. X - Metabolic Acidosis...

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1

A Case Study on Mrs. X

Department of Graduate Nursing, The University of Texas at Arlington College of Nursing and Health Innovation NURS 5315: Advanced Pathophysiology Professor: Allison Tuppeny October 03, 2020

2 A Case Study on Mrs. X This is a case study on Mrs. X who presents with an acid-base imbalance known as metabolic acidosis. This is evidenced by her lab values, and signs and symptoms. She needs dialysis to filter out her kidneys of excess hydrogen and return her body to its normal pH balance of 7.4. 1.

The clinical scenario is most consistent with which acid base imbalance? You may simply list your answer below using a bullet point format. This does not have to be in a complete sentence. 

2.

Metabolic Acidosis What data in the clinical scenario supports your diagnosis? Make sure to interpret the

lab values you list below. You may simply list your answers below using a bullet point format. This does not have to be in a complete sentence. Interpret the labs that you list as part of your answer by indicating normal, high, or low. 

3.

CO2 at 10mEq/L (low)

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BUN and creatine-80/8.0 mg/dL (high/high)

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Anion gap 26 mEq/L (High)

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Potassium-6.0mEq/L (high)

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Hemoglobin 10.4 g/dL (low)

What is the cause of Ms. X’s acid base disorder? You may simply list your answer below using a bullet point format. This does not have to be in a complete sentence. 

Chronic kidney disease

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Missed two dialysis sessions

4. Describe the key pathophysiologic concepts of the diagnosis in question 1. To answer this

3 question completely, you must answer all of the sub-questions below using complete sentences. Each sub-question may be answered in 1-6 sentences. a. What is the chemical buffer system? What is the role of the buffer system in maintaining acid base homeostasis? The chemical buffer system maintains acid base balance in the lungs and the kidneys, along with bicarbonate, phosphate, plasma proteins and hemoglobin. The role of the buffers is to maintain an optimal pH balance in the body by managing levels of hydrogen ions, which alter pH in the body. Buffers work by absorbing excess H+ or OHions, which alter pH homeostasis. The two most crucial plasma buffers are bicarbonatecarbonic acid and hemoglobin (McCance & Huether, 2019). b. How does the answer you identified in question 3, cause this acid base disorder? The kidneys are not functioning properly to excrete the excess acid in the body, there is a build-up of excess H+ ions. The patient needs dialysis to maintain homeostasis and rid the body of excess acids. The kidneys are unable to reabsorb filtered bicarb due to her renal failure and her buffer systems are not working to maintain an acid-base balance (McCance & Huether, 2019). c. What effect does this acid base disorder have on calcium? Describe how this acid base disorder alters calcium homeostasis. Due to the increased H+ ions, less Ca+ ions are binding with albumin increasing blood calcium levels. Hypercalcemia can also alter PTH levels in the body, which can result in hyperparathyroidism (McCance & Huether, 2019). d. What effect does this acid base disorder have on potassium? Describe how this acid base disorder alters potassium homeostasis.

4 During acidosis the cell membrane active transport is not effectively working, thereby altering potassium to shift to the extracellular fluid. Which consequently elevates serum potassium in the body (McCance & Huether, 2019). 5. For what actual or potential complications related to the diagnosis in question 1 does she need to be monitored? You may simply list your answer(s) below using a bullet point format. This does not have to be in a complete sentence. 

Changes in neurological, respiratory, gastrointestinal and cardiovascular systems

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Headache and lethargy may be present in early stages of acidosis

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Coma in severe acidosis

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Ventricular dysrhythmias

5 Reference McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier....