Table of contents

1. Introduction to Anatomy & Physiology5h 43m
2. Cell Chemistry & Cell Components12h 36m
3. Energy & Cell Processes10h 6m
4. Tissues & Histology10h 3m
5. Integumentary System2h 20m
6. Bones & Skeletal Tissue2h 16m
7. The Skeletal System2h 35m
8. Joints2h 17m
9. Muscle Tissue2h 33m
10. Muscles1h 11m
11. Nervous Tissue and Nervous System1h 35m
12. The Central Nervous System1h 6m
- Introduction to the Central Nervous System
  18m
- The Cerebrum
  48m
13. The Peripheral Nervous System1h 26m
14. The Autonomic Nervous System1h 38m
15. The Special Senses2h 41m
16. The Endocrine System2h 48m
17. The Blood3h 22m
18. The Heart3h 42m
19. The Blood Vessels3h 35m
20. The Lymphatic System3h 16m
21. The Immune System14h 37m
22. The Respiratory System3h 20m
23. The Digestive System2h 5m
24. Metabolism and Nutrition4h 0m
25. The Urinary System2h 39m
26. Fluid and Electrolyte Balance, Acid Base Balance37m
27. The Reproductive System2h 5m
28. Human Development1h 21m
29. Heredity3h 32m

26. Fluid and Electrolyte Balance, Acid Base Balance

Acid-Base Balance

Anatomy & Physiology

26. Fluid and Electrolyte Balance, Acid Base Balance

Acid-Base Balance

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Problem 26

Textbook Question

After falling into an abandoned stone quarry filled with water and nearly drowning, a young boy is rescued. In assessing his condition, rescuers find that his body fluids have high PCO₂ and lactate levels and low PO₂ levels. Identify the underlying problem and recommend the necessary treatment to restore homeostatic conditions.

Verified step by step guidance

Step 1: Understand the physiological implications of the boy's condition. High PCO₂ (partial pressure of carbon dioxide) indicates hypercapnia, which is an excess of CO₂ in the blood. Low PO₂ (partial pressure of oxygen) suggests hypoxemia, a deficiency of oxygen in the blood. Elevated lactate levels point to lactic acidosis, which occurs when cells switch to anaerobic metabolism due to insufficient oxygen supply.

Step 2: Analyze the cause of these imbalances. The boy's near-drowning experience likely led to impaired gas exchange in the lungs, causing CO₂ retention and reduced oxygen intake. Additionally, the lack of oxygen forced his cells to rely on anaerobic respiration, producing lactate as a byproduct.

Step 3: Identify the immediate treatment goals. The primary objectives are to restore normal oxygen levels (PO₂), reduce CO₂ levels (PCO₂), and correct the acid-base imbalance caused by lactic acidosis.

Step 4: Recommend treatment interventions. Administer supplemental oxygen via a mask or nasal cannula to increase PO₂ levels. If necessary, use mechanical ventilation to support breathing and enhance gas exchange. To address lactic acidosis, intravenous fluids containing bicarbonate may be administered to buffer the excess acid and restore pH balance.

Step 5: Monitor the boy's condition closely. Regularly check arterial blood gases (ABGs) to assess PO₂, PCO₂, and pH levels. Ensure that oxygen delivery and ventilation are adequate, and adjust treatments as needed to maintain homeostasis.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

Acidosis

Acidosis refers to a condition in which the body fluids contain an excess of hydrogen ions, leading to a decrease in pH. In this scenario, the high PCO₂ levels indicate respiratory acidosis, likely due to hypoventilation or impaired gas exchange, which can occur after near-drowning. This condition can disrupt cellular functions and metabolic processes, necessitating prompt intervention.

Lactic Acidosis

Lactic acidosis occurs when there is an accumulation of lactic acid in the body, often due to anaerobic metabolism when oxygen levels are low. The elevated lactate levels in the boy's body fluids suggest that his tissues were not receiving adequate oxygen, leading to anaerobic respiration. This condition can result from prolonged hypoxia, which is critical to address in treatment.

Homeostasis

Homeostasis is the body's ability to maintain stable internal conditions despite external changes. In this case, the boy's low PO₂ levels indicate a failure to adequately oxygenate blood, disrupting homeostasis. Restoring homeostasis may involve administering oxygen, correcting acid-base imbalances, and ensuring proper ventilation to stabilize his physiological state.

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Textbook Question

Respiratory acidosis develops when the blood pH is:

(a) Increased due to a decreased blood P𝒸ₒ₂ level

(b) Decreased due to an increased blood P𝒸ₒ₂ level

(d) Decreased due to a decreased blood P𝒸ₒ₂ level

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Textbook Question

Metabolic alkalosis occurs when:

(a) Bicarbonate ion concentrations become elevated

(b) A severe bicarbonate loss occurs

(d) Ketone bodies are generated in abnormally large quantities

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Textbook Question

Distinguish between respiratory and metabolic disorders that disturb acid-base balance.

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Textbook Question

What is the difference between metabolic acidosis and respiratory acidosis? What can cause these conditions?

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Textbook Question

Refer to the diagnostic flowchart in Spotlight Figure 27–18. Use information from the blood test results in the accompanying table to categorize the suspected acid-base disorders of the patients represented in the table.

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Textbook Question

How do respiratory and renal mechanisms support the buffer systems?

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Textbook Question

Differentiate between respiratory compensation and renal compensation.

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Textbook Question

The most recent advice from medical and nutritional experts is to monitor one’s intake of salt so that it does not exceed the amount needed to maintain a constant ECF volume. What effect does excessive salt ingestion have on blood pressure?

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