Initially, Mr. K.B. lost water, sodium in the mucus content, and hydrogen and ch
ID: 90223 • Letter: I
Question
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 Fig. 2-9). 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 the serum raise serum pH, and the result is "hypochloremic alkalosis." Which compartments are likely to be affected in this case by early fluid loss? Explain how a loss of sodium ions contributes to dehydration. Describe the early signs of dehydration in Mr. K.B.Explanation / Answer
1) In early stages of dehydration, when the fluid loss is between 0% to 5%, the compartment most likely to be affected early is the extracellular fluid compartment.
2) When sodium levels are low in the blood due to loss of sodium ions, the water present in the bloodstream will leave the blood and enter into the cells causing them to swell. Thus hyponatremia will lead to dehydration.
3) The early signs of dehydration in Mr. K.B. are increased thirst, dry mouth, decreased urinary frequency, dark colored urine, fatigue, dizziness, confusion, increased heart rate and pulse rate, decreased blood pressure and headache.