Q37: A patient arrives in the emergency room apparently in cardiogenic shock due to a massive heartattack. His initial arterial blood sample reveals the following concentrations of ions:SodiumBicarbonateFree calciumPotassiumpHTo correct the acidosis, the attending physician begins an infusion of sodium bicarbonate and after 1 hrtakes another blood sample, which reveals the following values:SodiumBicarbonateFree calciumPotassiumpH137 mmol/L14 mmol/L2.8 mmol/L4.8 mmol/L7.16138 mmol/L22 mmol/L2.3 mmol/L4.5 mmol/L7.34What is the cause of the decrease in calcium ion concentration?A. The increase in arterial pH resulting from the sodium bicarbonate infusion inhibited parathyroidhormone secretionB. The increase in pH resulted in the stimulation of osteoblasts, which removed calcium from thecirculationC. The increase in pH resulted in an elevation in the concentration of HPO42, which shifted theequilibrium between HPO42 and Ca11 toward CaHPO4Answer: CD. The increase in arterial pH stimulated the formation of 1,25-dihydroxycholecalciferol, which resultedin an increased rate of absorption of calcium from the gastrointestinal tract

Answered: Q37: A patient arrives in the emergency…

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Question

Q37: A patient arrives in the emergency room apparently in cardiogenic shock due to a massive heart
attack. His initial arterial blood sample reveals the following concentrations of ions:
Sodium
Bicarbonate
Free calcium
Potassium
pH
To correct the acidosis, the attending physician begins an infusion of sodium bicarbonate and after 1 hr
takes another blood sample, which reveals the following values:
Sodium
Bicarbonate
Free calcium
Potassium
pH
137 mmol/L
14 mmol/L
2.8 mmol/L
4.8 mmol/L
7.16
138 mmol/L
22 mmol/L
2.3 mmol/L
4.5 mmol/L
7.34
What is the cause of the decrease in calcium ion concentration?
A. The increase in arterial pH resulting from the sodium bicarbonate infusion inhibited parathyroid
hormone secretion
B. The increase in pH resulted in the stimulation of osteoblasts, which removed calcium from the
circulation
C. The increase in pH resulted in an elevation in the concentration of HPO42, which shifted the
equilibrium between HPO42 and Ca11 toward CaHPO4
Answer: C
D. The increase in arterial pH stimulated the formation of 1,25-dihydroxycholecalciferol, which resulted
in an increased rate of absorption of calcium from the gastrointestinal tract

Expert Solution

Introduction

A disturbance in the body's acid-base balance characterises metabolic acidosis, a dangerous electrolyte disease. Increased acid production, bicarbonate loss, and a diminished ability of the kidneys to eliminate extra acids are the three main underlying causes of metabolic acidosis. Acidemia, which is defined as arterial blood pH less than 7.35, can result from metabolic acidosis. [7] Since acidemia and acidosis do not necessarily coexist, pH levels in people with metabolic acidosis can range from low to high. Hydrogen ion concentrations also depend on the coexistence of other acid-base disorders.