26. Fluid and Electrolyte Balance, Acid Base Balance

Two substances secreted into the proximal convoluted tubules in exchange for sodium ions are:

a. Ammonium ions

b. Bicarbonate

c. Calcium

d. Chloride

e. Hydrogen ions

f. Magnesium

g. Phosphate

h. Potassium

i. Sodium

j. Water

Two ions produced during catabolism of glutamine are:

a. Ammonium ions

b. Bicarbonate

c. Calcium

d. Chloride

e. Hydrogen ions

f. Magnesium

g. Phosphate

h. Potassium

i. Sodium

j. Water

In an individual with metabolic acidosis, a clue that the respiratory system is compensating is provided by:

a. High blood bicarbonate levels

b. Low blood bicarbonate levels

c. Rapid, deep breathing

d. Slow, shallow breathing

Describe the role of the respiratory system in controlling acid-base balance.

Explain how the chemical buffer systems resist changes in pH.

Explain the relationship of the following to renal secretion and excretion of hydrogen ions:

Plasma carbon dioxide levels

Phosphate

Sodium bicarbonate reabsorption

For each of the following sets of blood values, name the acid-base imbalance (acidosis or alkalosis), determine its cause (metabolic or respiratory), decide whether the condition is being compensated, and cite at least one possible cause of the imbalance. Problem 1: pH 7.63; Pco₂ 19 mm Hg; Hco₃⁻ 19.5 mEq/L Problem 2: pH 7.22; Pco₂ 30 mm Hg; Hco₃⁻ 12.0 mEq/L

Explain how emphysema and congestive heart failure can lead to acid-base imbalance.

During a routine medical checkup, Shelby, a 26-year-old physiotherapy student, is surprised to hear that her blood pressure is 180/110. She also has a rumbling systolic and diastolic abdominal bruit (murmur) that is loudest at the mid-epigastric area. Her physician suspects renal artery stenosis (narrowing). She orders an abdominal ultrasound and renal artery arteriography, which confirm that Shelby has a small right kidney and the distal part of her right renal artery is narrowed by more than 70%. Her physician prescribes diuretics and calcium channel blockers as temporary measures, and refers Shelby to a cardiovascular surgeon. Explain the connection between Shelby's renal artery stenosis and her hypertension. Why is her right kidney smaller than her left? What would you expect Shelby's blood levels of K⁺, Na⁺, aldosterone, angiotensin II, and renin to be?

What happens to the pH of a solution when hydrogen ions are added?

a. The pH increases.

b. The pH decreases.

c. The pH does not change.

d. The pH does not measure hydrogen ion concentration.

Mark the following statements as true or false. If a statement is false, correct it to make a true statement.

e. Chloride ions are generally reabsorbed from the kidneys, along with bicarbonate ions.