Reference no: EM133855087
Assignment:
After the patient was admitted to in-patient rehabilitation, the patient's screening results showed stable vital signs with a heart rate of 76bmp, blood pressure of 115/76, SpO2 of 97% and intact integuments. The physiotherapist proceeded to choose various outcome measures to obtain the patient's mental status at baseline and monitor any changes over time.
1. 1. Why do conditions that cause retention of sodium, such as cardiac failure, result in low serum sodium?
2. What is meant by 'free water'?
2. Why is there a difference in the pattern of oedema in nephrotic syndrome and cardiac oedema? How is it related to the interstitial spaces and all that? I am confused.
3. Why is there a difference in the clinical presentation of oedema due to renal failure and oedema due to cardiac failure, and how is this related to the loose nature of the interstitial tissue in the periorbital area?
4. What treatment is recommended for recurrent attacks of generalized swelling, with angio-oedema, in a middle-aged female patient?
5. Is an osmotic diuresis, due to hyperglycaemia for instance, a cause of both hyponatraemia and hypernatraemia. Please explain how this can be the case.
6. What is the mechanism of β2-agonists (albuterol) in correcting hyperkalaemia in emergency? How does it cause a shift of potassium?
7. Why do we give sodium lactate along with sodium bicarbonate in acidotic patients? How does sodium lactate then act?
8. How does hypochloraemia alone cause a metabolic alkalosis?
9. I have read the part concerning acid-base imbalances and I would like to ask about two things:
1. Why is there a higher concentration of anions (18) on measuring the anion gap while there is a high concentration of immeasurable anions? I would have expected a higher concentration of cations because most of them are measurable.
2. Could you explain to me in more details how NaCO3 loss or HCl retention could lead to normal anion gap acidosis?
10. What is the exact formula for calculating the serum anion gap?