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 L2.4

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?

Verified step by step guidance

Understand the condition: Diabetic ketoacidosis (DKA) is a condition where the body produces excessive ketone bodies due to a lack of insulin. These ketone bodies are acidic, leading to metabolic acidosis, which lowers blood pH.

Identify the body's response to metabolic acidosis: The body compensates for metabolic acidosis by attempting to restore blood pH to normal. This is achieved through the respiratory system, which can adjust the levels of carbon dioxide (CO2) in the blood.

Recall the relationship between CO2 and pH: CO2 combines with water in the blood to form carbonic acid (H2CO3), which dissociates into hydrogen ions (H⁺) and bicarbonate ions (HCO3⁻). An increase in CO2 leads to more H⁺, lowering pH, while a decrease in CO2 reduces H⁺, raising pH. This is described by the equation:

{CO}_{2} + H

₂O ⇌ H₂CO₃ ⇌ H⁺ + HCO₃^-.

Determine the respiratory compensation: To counteract the acidosis, the patient will hyperventilate (breathe faster and deeper). Hyperventilation expels more CO2 from the body, reducing its concentration in the blood. This shifts the equilibrium of the above reaction to the left, decreasing H⁺ concentration and raising blood pH.

Summarize the effect of hyperventilation: By increasing the rate and depth of ventilation, the patient reduces CO2 levels, which helps to partially compensate for the metabolic acidosis caused by diabetic ketoacidosis. This is an example of the respiratory system working to maintain acid-base homeostasis.

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Key Concepts

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

Diabetic Ketoacidosis (DKA)

Diabetic ketoacidosis is a serious complication of diabetes characterized by high levels of ketone bodies in the blood, leading to metabolic acidosis. It typically occurs in individuals with type 1 diabetes when insulin levels are insufficient, causing the body to break down fat for energy, resulting in the production of ketones. Symptoms include nausea, vomiting, abdominal pain, and altered mental status.

Metabolic Acidosis

Metabolic acidosis is a condition where there is an excess of acid in the body due to increased production of acids or decreased ability to excrete them. In DKA, the accumulation of ketone bodies lowers blood pH, leading to acidosis. The body attempts to compensate for this by increasing ventilation to expel carbon dioxide, which helps raise blood pH back toward normal levels.

Ventilation and Compensation

Ventilation refers to the process of breathing, which can be altered in response to changes in blood pH. In metabolic acidosis, patients typically hyperventilate to decrease carbon dioxide levels, which helps to raise blood pH. This compensatory mechanism is known as respiratory compensation, where the body adjusts the rate and depth of breathing to counteract the effects of acidosis.

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Related Practice

Textbook Question

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

b. Renal compensation for acid-base disturbances begins within minutes, whereas respiratory compensation begins within several hours.

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Textbook Question

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

c. Respiratory compensation for metabolic acidosis consists of hypoventilation.

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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.

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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.

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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.

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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?

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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?)

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Multiple Choice

Hyperventilation can lead to __________.

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