Case-2: Patient History L.S. is brought to the emergency department for manageme
ID: 90217 • Letter: C
Question
Case-2: Patient History
L.S. is brought to the emergency department for management of acute mushroom poisoning. Her respirations are slow and shallow, and she is nonresponsive. She is admitted to the critical care unit to be closely monitored for the development of respiratory failure and renal failure, which often accompany mushroom poisoning. Her urine output is decreased to about 20 ml/hr. Her laboratory values are serum K+ = 5.7 mEq/L; arterial blood gases (ABGs): pH = 7.13, PaCO2 = 56 mm Hg, PaO2 = 89 mm Hg, HCO3- = 18 mEq/L.
Analyze this case study and answer the next four questions that follow.
Case-2 Question-1
What is the most likely cause of L.S.’s potassium imbalance? (select all that apply)
Case-2: Question-2
What is the relationship between acid-base balance and serum potassium level? (select all that apply)
Case-2: Question-3
Categorize and explain the probable cause of L.S.’s acid-base disorder. (select all that apply)
Case-2: Question-4
Can L.S. compensate for her acid-base disorder? (select all that apply)
The most likely cause of L.S.’s potassium imbalance is impaired kidney function.Explanation / Answer
Case 2 Que 1:
As said in the case instant serum
Hyperkaliemia usually reported in acute renal failure, which may occur due to low secretion of K+ due to decreased GFR (glomerulus filtration rate), damage in sites of kidney, which is secrete K+, extracellular swing of in K+ due to the following due to acidosis.
Que 2
Alkalosis contributes to hypokalemia.
Alkalosis contributes to hyperkalemia,
as increased proton concentration enhances activity of sodium ion and proton exchanger. Also, NH4 ion play a role in it.
que 3
L.S. has metabolic acidosis is mainly due to lactic acid accumulation, which is categorized by a high AG (anion gap).
Que 4:
She will not be able to compensate on her own because the lungs and the kidneys are malfunctioning. This can be explained by the fact that mainly buffering in body occur in through the bicarbonate buffer which is managed by proper respiration. Similarly, kidney also help by elimination of surplus ion but that too is not working well.