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

Previous problemNext problem

Problem L3.3

Textbook Question

Ms. Johanssen is a patient in the hospital. The nurse examines her laboratory reports and notices that she has developed hyperkalemia and acidosis over the past several days. On closer examination of her medical chart, the nurse also sees that her physician recently doubled her dose of spironolactone, an aldosterone-blocking diuretic. How does this explain her laboratory findings?

Verified step by step guidance

Understand the role of aldosterone: Aldosterone is a hormone that promotes sodium reabsorption and potassium excretion in the kidneys. It also helps regulate acid-base balance by promoting hydrogen ion excretion. Spironolactone, as an aldosterone-blocking diuretic, inhibits these processes.

Explain hyperkalemia: By blocking aldosterone, spironolactone reduces potassium excretion in the kidneys. This leads to an accumulation of potassium in the blood, a condition known as hyperkalemia.

Explain acidosis: Aldosterone also promotes the excretion of hydrogen ions in the kidneys. When aldosterone is blocked by spironolactone, hydrogen ions are retained, leading to a decrease in blood pH, which is referred to as acidosis.

Connect the findings to the medication dose: The doubling of the spironolactone dose would amplify its aldosterone-blocking effects, further reducing potassium and hydrogen ion excretion. This explains the worsening hyperkalemia and acidosis observed in Ms. Johanssen's laboratory reports.

Summarize the physiological impact: The combination of hyperkalemia and acidosis is a direct result of the increased spironolactone dose, which disrupts the normal balance of potassium and hydrogen ions regulated by aldosterone in the kidneys.

Verified video answer for a similar problem:

This video solution was recommended by our tutors as helpful for the problem above

Play a video:

Was this helpful?

Key Concepts

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

Hyperkalemia

Hyperkalemia refers to an elevated level of potassium in the blood, which can lead to serious cardiac and muscular complications. It often occurs when the kidneys are unable to excrete sufficient potassium, or when potassium intake exceeds the body's ability to eliminate it. In the context of diuretics, certain medications, like spironolactone, can cause potassium retention, contributing to hyperkalemia.

Acidosis

Acidosis is a condition characterized by an excess of acid in the body fluids, leading to a decrease in blood pH. It can result from various factors, including respiratory issues or metabolic disturbances. In patients with hyperkalemia, acidosis can occur as potassium ions shift from the intracellular to the extracellular space, causing hydrogen ions to move into cells, thus increasing acidity in the blood.

Spironolactone

Spironolactone is a potassium-sparing diuretic that works by blocking the action of aldosterone, a hormone that promotes sodium retention and potassium excretion. By inhibiting aldosterone, spironolactone leads to increased sodium excretion while retaining potassium. This mechanism can explain the patient's hyperkalemia, especially after the recent increase in her medication dosage, which may have exacerbated her potassium levels.

Previous problemNext problem

1:29m

Watch next

Master Acids and Bases with a bite sized video explanation from Bruce Bryan

Start learning

Related Videos

Related Practice

Textbook Question

Mark the following statements as true or false. If a statement is false, correct it to make a true statement.

d. Renal compensation for metabolic alkalosis consists of reabsorption of hydrogen ions and secretion of bicarbonate ions.

280

views

Textbook Question

Mark the following statements as true or false. If a statement is false, correct it to make a true statement.

e. You would expect to find an elevated Pco₂ in arterial blood gas analysis of a patient with respiratory acidosis.

229

views

Textbook Question

Diabetic ketoacidosis is characterized by an increased level of ketone bodies, which causes metabolic acidosis. A patient in diabetic ketoacidosis will have an altered rate of ventilation. Will the patient be hyperventilating or hypoventilating? How will a change in the rate and depth of ventilation compensate for an acidosis that is metabolic in nature?

205

views

Textbook Question

Elise Anderson is a 6-year-old girl who presents to the emergency department with a history of vomiting for the past 3 days. The nurse notices that her respiratory rate is abnormally low. What is the likely reason for this change in ventilation? Predict what Elise's arterial blood gas values would show.

227

views

Textbook Question

A laboratory printout of arterial blood gases indicates that a patient has an increased Pco₂ , decreased pH, and normal bicarbonate ion concentration. Is this patient in acidosis or alkalosis? Is the pH disturbance respiratory or metabolic in nature? Explain your reasoning. How long do you think the patient has had this pH disturbance? (Hint: Look at the bicarbonate ion concentration. What system controls the concentration of bicarbonate ions, and how quickly does it compensate for pH disturbances?)

250

views

Multiple Choice

Hyperventilation can lead to __________.

One way the kidneys maintain HCO₃^– balance is by __________.

931

views

rank