You have just admitted Mary Roberts, a 70-year-old woman, to the hospital for GI bleeding. Her blood pressure is 130/80, pulse 80/min and irregular, respirations 18/min, and temperature 99.2. Mrs. Roberts denies pain at this time although she appears anxious and very pale. Her medical history includes lung cancer that was diagnosed two weeks ago, peptic ulcer disease with reflux esophagitis, and "fluid retention". Admission lab work shows a plasma Na of 152 mEq/L and K of 2.8 mEq/L.

Bob Trotts has an enteropathogenic E. coli infection resulting in severe diarrhea for 2 days. This could produce which of the following:

(1) acidosis

(2) alkalosis

(3) increased respiration

(4) decreased respiration

(5) increased ADH secretion

(6) increased renin secretion

(7) increased urine concentration

Select one:

a. 1, 3, 5, 6, 7

b. 2, 4, 5, 6, 7

c. 1, 3, 6

d. 2, 4, 5, 7

e. 1, 4, 5, 7

Answer: the correct answer is a. 1, 3, 5, 6, 7

Explanation:

acidosis. - acidosis occurs when the acid accumulates when bicarbonate (a base) is lost. Acidosis is classified as breathing acidosis and metabolic acidosis. The breathing acidosis occurs when there is too much carbon dioxide in the body.

Increased respiration. - breathing that is more rapid than normal. Tachypnea is defined as an elevated respiratory rate, or more simply. A normal respiratory rate can vary depending on age and activity but is usually between 12 and 20 breaths per minute for a resting adult.

Inappropriate (increased) ADH secretion causes an unrelenting increase in solute-free water ("free water") absorption by the kidneys, with two effects. First, in the extracellular fluid (ECF) space, there is a dilution of blood solutes, causing hypoosmolality, including a low sodium concentration - hyponatremia (term that is used when the level of sodium in the blood is too low).

Renin's primary function is therefore to eventually cause an increase in blood pressure, leading to restoration of perfusion pressure in the kidneys. Renin is secreted from juxtaglomerular kidney cells, which sense changes in renal perfusion pressure, via stretch receptors in the vascular walls.

Increased urine concentration may be due to different conditions, such as: Heart failure. Loss of body fluids (dehydration) from diarrhea or excessive sweating. Narrowing of the kidney artery (renal arterial stenosis).