Alright, so for this week we just need to respond to one of the other students, and it looks like we don\’t have to persuade the student one way or another, just respond, basically. Here is the post we\’ll respond to (by H.A.):
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\”The body\’s PH provides a physiological picture at any given time. Therefore, understanding PH helps correct underlining physiological distresses. The optimal PH at which the human body functions is 7.40, a physiological neutral status. If the body PH is less than 7.40, it is an acidotic state, and values above 7.40 are alkalinity. That is because the body uses carbon dioxide (CO2) to correct acidity or alkalinity in the lungs. Also, the kidneys use bicarbonates (HCO3) to fix imbalances in the PH in the body. Therefore, it is respiratory acidosis or respiratory alkalosis when physiological conditions or distress are of respiratory origin. In contrast, it is metabolic acidosis or alkalosis when the source is outside the lungs.
Now, in the case study above, it is evident that Mr. B is in a metabolic acidotic state. Mr. B suffered a Myocardial infarction which is cardiac originated. More so a P.H. of 7.22 is acidotic. In metabolic distress, the PH and the bicarbonate trend in the same direction. Normal value for Bicarb is 22-26 mEq/L. When in distress, the body produces nonvolatile acids, such as lactic acid (Brashers & Huether, 2020). The nonvolatile acid in the bloodstream leads to a condition referred to as acidemia. Because this is a metabolic acidotic issue, the respiratory system will attempt to compensate by increasing the rate and depth of breath. The lungs eliminate CO2 and can increase the amount of carbon dioxide eliminated. Acid from the arterial blood is converted to CO2 in the lungs; this compensatory mechanism shows a low to normal PCO2 value at 30mm (35-45).
A study by (Dragic et al., 2021) finds that in patients with extreme metabolic acidosis, a \”timely and structured approach can shift the boundaries of reversibility for some of the most conditions.\” Correcting the PH imbalance is crucial to successful treatment. Mr. B is in a metabolic acidotic state caused by the Myocardial Infarction with respiratory compensation.
References
Brashers, V.L., & Huether, S.E. (2020). Alteration of pulmonary function in children. In S.E. Huether, K.L. McCance, V.L. Brashers & NS. Rote (Eds.), Understanding pathophysiology (7th ed., pp. 123-133). Elsevier.
Dragic, S., Momcicevic, D., Zlojutro, B., Jandric, M., Kovacevic, T., Djajic, V., Gajic, O., & Kovacevic, P. (2021). Successful Outcomes of Critically III Patients with Extreme Metabolic Acidosis Treated with Structured Approach: Case Series. Clinical Medicine Insights: Case Reports, 14, 1 6. https://doiorg.wilkes.idm.oclc.org/10.1177/11795476211025138\”
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I\’ve downloaded that student\’s document on Word, and also the rubric.
NSG 530, Module 1, Reply 1
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NSG 530, Module 1, Reply 1
The original discussion of the student was well documented in a concise and precise manner. The pH of the body is indeed an important physiological process. Certain cardiovascular diseases can lead to an alteration of the body pH, leading to several health conditions (Bajwa et al., 2022). The patient in the case study was diagnosed with myocardial infarction. This diagnosis was made after several tests had been run. The test results of the patient included Ph7.22, PCO2 30 mm, Hg pO2 70 mm, Hg O2 sat 88%, and HCO3 22 meq/liter. The doctor noticed acid-base disturbances which were believed to have been caused by the underlying condition.
It is indeed true that the body’s pH has significant importance in its physiological functioning. The pH indicated from the tests indeed showed acidosis. According to the results, PCO2 30 mmHg was recorded while the normal range is between 35 to 45 mmHg (Bajwa et al., 2022). Furthermore, Ph7.22 was recorded while the normal range should be between 7.35 and 7.45. A decrease in pH below this range is acidosis, and an increase above this range is alkalosis (Bajwa et al., 2022). Therefore, an acid-base disturbance is seen in the patient’s bloodstream. On average, the pH of the body is 7.40. In the original discussion, the student used the average (7.40) measure without considering the upper and lower limits (the range), which are 7.45 and 7.35 respectively.
Based on the discovery above, the patient also developed respiratory acidosis as a result of the underlying condition. Acidosis (low blood pH) is common in patients with myocardial infarction and may contribute to dysrhythmias among patients (Saleh & Ambrose, 2018). The student is right in the original discussion by stating that when one is in distress, the body may produce acids leading to some conditions. In acute myocardial infarction, the combination of a fall in cardiac output and arterial hypoxemia leads to tissue hypoxia, metabolic acidosis, and a fall in plasma bicarbonate due to a rise in lactic acid.
Acidosis in myocardial infarction happens because it causes the body to produce too much acid. Blood normally becomes more turbulent when a patient experiences myocardial infarction leading to blood clot formation (Saleh & Ambrose, 2018). This incident can in turn lead to atherosclerotic plaque that may block coronary arteries, hence, preventing the myocardium from receiving oxygen (Bajwa et al., 2022). Also, during this incident, anaerobic glycolysis may occur which will lead to the production of lactic acid. This statement explains the low pH (Acidosis) witnessed in the results.
References
Bajwa, G. S., Hussain, A., & Javaid, M. M. (2022). How to work up an adult patient with metabolic acidosis. British Journal of Hospital Medicine, 1-11. https://doi.org/10.12968/hmed.2021.0582
Saleh, M., & Ambrose, J. A. (2018). Understanding myocardial infarction. F1000Research, 7. https://doi.org/10.12688/f1000research.15096.1