Which of the following responses would also be expected to occur in the patient who has the following conditions? Low arterial pressure, reduced tissue turgor, and the following arterial blood values:
pH = 7.69
[HCO3 = 57 mEq/L
PCO2 = 48 mm Hg
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A. Hyperventilation B. Decreased K+ secretion by the distal tubules C. Increased ratio of H 2PO4- to HPO4-2 in urine D. Exchange of intracellular 11 + for extra cellular K+
Exchange of intracellular 11 + for extra cellular k+- first, the acid-base disorder must be diagnosed. alkaline ph, with increased hco3- and increased pco2, is consistent with metabolic alkalosis with respiratory compensation. the low blood pressure and decreased turgor suggest extracellular fluid (ecf) volume contraction. the reduced [h+] in blood will cause intracellular h+ to leave cells in exchange for extracellular k. the appropriate respiratory compensation is hypoventilation, which is responsible for the elevated pco2 . excretion in urine will be decreased, so less titratable acid will be excreted. k+ secretion by the distal tubules will be increased because aldosterone levels will be increased secondary to ecf volume contraction.