Pathophysiology Case
What acid-base disorder did David have? What was its etiologoy?
David is having a Diabetic Ketoacidosis acid disorder. Its etiology is a metabloic acid disorder from the burning of fatty acids that produces acidic ketones
Did Davids lungs provide the expected degree of “respiratory compensation”?
Yes it did. For the body to try to maintain homeostasis of pH, it will change the rate of ventilation. Due to the lower pH from the build up of acids in the body, it attempts to expel CO2 by increasing breathing.
. Why were glucose and K+ added to the infusion after his plasma glucose and K+ levels were corrected to normal?
If not added, the patient may continue to lose glucose and K+ during the rehydration process. During the rehydration process, hydrogen ions How did the initial treatment with insulin and saline help to correct Davids fluid and electrolyte disturbances?
Saline helped rehydrate David, which would reduce his symptoms related to dehydration, and introducing insulin allows cells their normal uptake of glucose and electrolytes.What factors contributed to Davids elevated plasma K+ concentration (hyperkalemia)? Was his K+ balance positive, negative, or normal?
Insulin helps potassium entry into cells. Since David did not take his insulin, potassium began to move out of the cells, and into the blood stream, raising his potassium levels. His K+ levels were elevated in the blood, as evidenced by the 5.8mEq/L in the blood test, but within the cell he would be negative in potassium due to the lack of insulin. Why was his pulse rate increased?
The patients tachycardia is in response to electrolyte imbalance frequent urination. The loss of water, decreases blood pressure, so the heart rate increases to maintain BP. Why was David so thirsty at 7 a.m.?
The combination of