Case Study Discussion Scenario
Mr. K. B. is age 81 and has had gastritis with severe vomiting for three days. He has a history of heart problems and is presently feeling dizzy and lethargic. His eyes appear sunken, his mouth is dry, he walks unsteadily, and he complains of muscle aching, particularly in the abdomen. He is thirsty but is unable to retain food or fluid. A neighbor has brought Mr. K. B. to the hospital, where examination shows that his blood pressure is low, and his pulse and respirations are rapid. Laboratory tests demonstrate elevated hematocrit, hypernatremia, decreased serum bicarbonate, serum pH 7.35, and urine of high specific gravity (highly concentrated).
It is understood that thoughtful responses to your topic question(s) will take some time and thought. Please organize your thoughts before creating your initial post.
Based on your assigned team, create an initial post by answering all questions for your assigned part, making sure to address all components of all questions.
By Day 3, post your initial response to your assigned part of the case study as a reply to the appropriate discussion thread. Please be sure to number the questions addressed and include all components of each question in your response. Each initial response must have a reference, including at least 2 scholarly references other than your text or course materials. Your post should be limited to 500 to 750 words and comprehensively address the questions posed.
Team A-Part 1: Day 1 – Early Stage
Week 2 Discussion Team A Worksheet (Word)
Initially, Mr. K .B. lost water, sodium in the mucus content, and hydrogen and chloride ions in the hydrochloric acid portion of the gastric secretions. Alkalosis develops for two reasons; the first being the direct loss of hydrogen ions and the second being the effects of chloride ion loss. When chloride ion is lost in the gastric secretions, it is replaced by chloride from the serum (see Figure 2.9 in your textbook). To maintain equal numbers of cations and anions in the serum, chloride ion and bicarbonate ion can exchange places when needed. Therefore, more bicarbonate ions shift into the serum from storage sites in the erythrocytes to replace the lost chloride ions. More bicarbonate ions in tserum raise serum pH, and the result is hyperchloremic alkalosis.
Explain how a loss of sodium ions contributes to dehydration. Why does this dehydration affect cell function? For more information on Loss of Sodium Ions see this: https://en.wikipedia.org/wiki/Sodium_in_biology
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