L.S. is brought to the emergency department for management of acute mushroom poi
ID: 3479658 • Letter: L
Question
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.
1A. What is the most likely cause of L.S.’s potassium imbalance? Explain the role of the kidney in potassium excretion.
B. What is the relationship between acid-base balance and serum potassium level?
C. What is the reason for L.S.’s low urine output? How should her fluids be managed?
D. Categorize and explain the probable cause of L.S.’s acid-base disorder.
E. Can L.S. compensate for her acid-base disorder? Why or why not?
F. How should her acid-base imbalance be medically managed?
Explanation / Answer
1A. answer- Mushroom is an high contet of potessium, it means in the presence of mushroom human body gets hyperkalemia. Thats why L.S's gets potessium imbalanced.
Role of kidney in Potessium excretion-
At the site of filtration ( glomerulus) the all potessium ions can be essily filtrated. After filtration potessium are re-absorb from the collecting duct. The surrounding wall of colleting duct is acidic in nature, where potessium can be re-absorb into the blood. ( Potessium play important role as a cation to falling pH like as H+ ions).
B. Answer- Acid- base balance may directly affected by the serum potessium level. Potessium have potencial effect to decreasing the pH. ( like proton ions)
It means whenever potessium level is incresing it will directly affect the acid-base balance by decresing pH.
C. answer- Reason of L.S's low urine output-
In acidic pH the ions and glucose are mostly re-absorb from the nephron and burning sensation also increase in urinary tract. In some cases the ions converted into crystel form in the nephron which decrease the urine out flow.
Fluids can be managed by decresing the pH of urine by using Disodium hydrogen citrate syrup and Diuretic ( note- potessium spairing diuretic must be avoid it will increase serum potessium level.
D. answer - Probable causes of L.S's acid-base disorder-
1- Serum and urine pH- due to high content of potessium food. It decrese in pH of urine and serum.
2.Urinary Tract Infection (UTI)- It may be possible LS.'s may have some issuses about UTI.
3.Alcohol Cosuption- Alcohol also responsible to cause acid-base balance desorder.
4. Other Body Disorder- Hyperglycemia, Peptic ulceration etc also may cause acid-base imbalance.
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