Week 5 Case Study: Fluid and Electrolyte/Acid-Base
1. Understanding that HCl is produced in the stomach and that he has been vomiting his
stomach contents, predict the acid/base imbalance that repeated vomiting will cause.
The cardinal findings in pyloric stenosis are dehydration, metabolic alkalosis,
hypochloremia, and hypokalemia. Loss of gastric fluid leads to volume depletion and loss of
sodium, chloride, acid (H+) and potassium. This results in a hypokalemic, hypochloremic
metabolic alkalosis. The kidneys attempt to maintain normal pH by excreting excess HCO3.The
kidneys attempt to conserve sodium at the expense of hydrogen ions, which can lead to
paradoxical aciduria. In more severe dehydration, renal potassium losses are also accelerated
owing to an attempt to retain fluid and sodium (OpenAnesthesia, 2011).
2. Predict the effect on blood chloride level from repeated vomiting?
Excessive vomiting leads to excess loss of water and electrolytes from the body.
Electrolytes such as sodium, potassium, calcium, magnesium, bicarbonates, and chloride ions are
essential for normal bodily functions. As water is lost during vomiting, the delicate balance of
electrolytes is also altered. Expelling the gastric acid contents causes the loss of chloride and
hydrogen ions which can lead to hypochloremic metabolic alkalosis, where there are high levels
of bicarbonate and carbon dioxide but low levels of chloride, leading to an increased blood pH.
In addition, there may be a low level of potassium (hypokalemia) (Mandal, 2019).
3. "Normal saline" is often used to treat dehydration. What does it mean for the saline to
be "normal"?
Normal saline contains sodium chloride (NaCl) and is isotonic. This means when given
through the IV, there should be no net movement of fluid or electrolyte into or out of the cells.
This study source was downloaded by 100000836546216 from CourseHero.com on 05-16-2022 13:33:50 GMT -05:00
https://www.coursehero.com/file/128813578/Week-5-Case-Study-Fluid-and-Electrolyte-Acid-Basedocx/
1. Understanding that HCl is produced in the stomach and that he has been vomiting his
stomach contents, predict the acid/base imbalance that repeated vomiting will cause.
The cardinal findings in pyloric stenosis are dehydration, metabolic alkalosis,
hypochloremia, and hypokalemia. Loss of gastric fluid leads to volume depletion and loss of
sodium, chloride, acid (H+) and potassium. This results in a hypokalemic, hypochloremic
metabolic alkalosis. The kidneys attempt to maintain normal pH by excreting excess HCO3.The
kidneys attempt to conserve sodium at the expense of hydrogen ions, which can lead to
paradoxical aciduria. In more severe dehydration, renal potassium losses are also accelerated
owing to an attempt to retain fluid and sodium (OpenAnesthesia, 2011).
2. Predict the effect on blood chloride level from repeated vomiting?
Excessive vomiting leads to excess loss of water and electrolytes from the body.
Electrolytes such as sodium, potassium, calcium, magnesium, bicarbonates, and chloride ions are
essential for normal bodily functions. As water is lost during vomiting, the delicate balance of
electrolytes is also altered. Expelling the gastric acid contents causes the loss of chloride and
hydrogen ions which can lead to hypochloremic metabolic alkalosis, where there are high levels
of bicarbonate and carbon dioxide but low levels of chloride, leading to an increased blood pH.
In addition, there may be a low level of potassium (hypokalemia) (Mandal, 2019).
3. "Normal saline" is often used to treat dehydration. What does it mean for the saline to
be "normal"?
Normal saline contains sodium chloride (NaCl) and is isotonic. This means when given
through the IV, there should be no net movement of fluid or electrolyte into or out of the cells.
This study source was downloaded by 100000836546216 from CourseHero.com on 05-16-2022 13:33:50 GMT -05:00
https://www.coursehero.com/file/128813578/Week-5-Case-Study-Fluid-and-Electrolyte-Acid-Basedocx/
