Acid-Base and Electrolyte Case Study Assignment Paper

1. Identify each of the abnormal laboratory findings in the above results. Specify how they differ from the normal range and identify what condition each abnormality indicates.

The case of the 85-year-old woman is critical and highlights events taking place at the hospital’s skilled nursing facility. Important aspects of the case are that the client has not been breathing well for the last two days and has been lethargic with dry and warm skin and a reduced urine output. The patient’s age is also a vital aspect to evaluate in this case and relates to her body’s ability to balance the bases and the electrolytes. According to the laboratory results the patient’s Na (sodium) levels are 147 mEq/L while the normal ranges of this electrolyte should be between 135 to 145 mEq/L. This is an indicator that the patient is suffering from a condition known as hypernatremia. The Cl (Chloride) levels of the patients are at 110 mEq/L while the normal ranges should be between 98 to 106 mEq/L an indicator that the patient is suffering from a condition known as hyperchloremia. The K (potassium) levels of the patients are 4.0 mEq/L while the normal ranges should be between 3.5 to 5.0 mEq/L which indicates the patient results fall within the normal ranges. The PH of the patient indicates she is 7.33 while the normal PH levels in a healthy person are between 7.35 7.45 and which indicates the patient has a condition known as acidosis. The PCO2 lab results of this patient show that she has 48 mm Hg while the normal range should be 35 to 45 mm Hg an indicator that the patient is suffering from respiratory acidosis. In addition, the HCO3 level of the patient is 27 mEq/L while the normal range should be 22 to 28 mEq/L which indicates the patient’s lab results fall within the normal range. The PO2 levels of the patient are 96 mm Hg while the normal range is 75 to 100 mm Hg which shows the patient’s lab results fall within normal ranges. Further, the Urine Specific Gravity of the patient according to lab results is 1.040 while the normal range is 1.005 to 1.030 an indication that the patient is suffering from a condition known as dehydration (Mahajan et al., 2024). Acid-Base and Electrolyte Case Study Assignment Paper

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2. What specific electrolyte disturbance does the patient have?

The patient in this case is suffering from an electrolyte disturbance known as hypernatremia which is the issue is high sodium levels and also the hyperchloremia that is associated with the high levels of chloride levels in the blood system. For instance, the sodium levels from the client are 147 mEq/L which brings about a condition known as hyperosmolar which is brought about by reduced total body water compared to electrolyte levels. The issue mostly affects elderly persons who have physical and mental issues and those with some acute infections. Others acquire this condition during hospitalization which is associated with their age. In general, the condition is brought about by restricted access to fluids or water or impaired thirst that is escalated by pathologic issues leading to loss of fluids (Mahajan et al., 2024).

On the other hand, hyperchloremia is brought about by an excess chloride amount in the blood and may caused by issues like diarrhea, medications, taking too much salt, and kidney disease. This condition occurs due to the presence of huge amounts of chloride in the body. It is important to note that chloride is an important electrolyte in the body and helps in maintaining a proper acid-base level across the body. This is crucial in the regulation of other fluids and helps in the transmission of impulses. The regulation of electrolytes is greatly done by kidneys and thus any issue of electrolyte imbalance is caused by an issue with organs. For example, issues like diabetes and critical dehydration have the ability to affect electrolyte levels (Mahajan et al., 2024). Acid-Base and Electrolyte Case Study Assignment Paper

3. What clinical manifestations would the nurse expect to see with this electrolyte abnormality presented above?

The clinical manifestations that a nurse should expect to see with this electrolyte abnormality include thirst, reduced urine output, seizures in extreme cases, lethargy, and dry, and sticky mucous membranes. Most of these clinical signs were evident from the patient and indicated an issue with her electrolyte balance. In addition, her age and the duration of hospitalization were a crucial indicator of these manifestations (Mahajan et al., 2024). These manifestations are an indicator that the patient might be starting to have other complex health issues like kidney problems.

4. If the patient had an increase in her potassium level, for what clinical manifestations would the nurse monitor?

In the situation where the patient had some increase in potassium levels also known as hyperkalemia then the nurse should closely monitor aspects of fatigue, nausea and vomiting, irregular heart rhythms or palpitations, and muscle weaknesses. This issue of high potassium in the blood occurs when the kidneys are not able to readily filter the contents. The potassium then builds up and ends up in the blood. This case leads to complex issues like heart damage that results in palpitations and severe cases can lead to heart attack. The condition is caused by potassium supplements and high potassium in the diet. Also, the issue might be caused by medications that reduce the patient’s kidneys’ ability to filter contents (Emektar, 2023). Acid-Base and Electrolyte Case Study Assignment Paper

5. What blood gas abnormality is seen in this patient? Discuss the rationale for your answer.

The blood gas abnormality seen in this patient is respiratory acidosis. This abnormality is indicated by a reduced PH and higher levels of PCO2. The issue is caused by instances when the lungs fail to eliminate all the carbon dioxide from the system hence the blood turns acidic. The lower PH reduces the ability of the blood to work as expected. It is important to note that sudden issues of respiratory acidosis might turn out to be fatal hence care should be taken with such patients (Patel, 2023).

6. What are the three major mechanisms of pH regulation? Provide a brief description of each.

The major mechanisms of PH regulation include buffer systems, respiratory regulation, and renal regulation. Buffer systems emerge as the immediate lines of body defense as a result of PH changes. This mechanism helps in neutralizing any instances of excess bases or acids in the body. On the other hand, respiratory regulation is the situation where the lungs decrease or increase the breathing rates and their ability to retain or expel carbon dioxide. Such regulations help in making major adjustments to the PH level. In addition, renal regulation involves the ability of the kidneys to retain or excrete the hydrogen ions and also the bicarbonate in making regulation of the PH for a long duration (Shaw, 2022). Acid-Base and Electrolyte Case Study Assignment Paper

 References

Emektar E. (2023). Acute hyperkalemia in adults. Turkish journal of emergency medicine, 23(2), 75–81. https://doi.org/10.4103/tjem.tjem_288_22

Mahajan, R., Shehjar, F., Qureshi, A. I., & Shah, Z. A. (2024). Hyperchloremia and Hypernatremia Decreased Microglial and Neuronal Survival during Oxygen-Glucose Deprivation/Reperfusion. Biomedicines, 12(3), 551. https://doi.org/10.3390/biomedicines12030551

Patel S, Sharma S. (2023). Respiratory Acidosis. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482430/

Shaw, I., & Gregory, K. (2022). Acid-base balance: a review of normal physiology. BJA education, 22(10), 396–401. https://doi.org/10.1016/j.bjae.2022.06.003 Acid-Base and Electrolyte Case Study Assignment Paper