Disorders of Fluid, Electrolyte and Acid-Base Balance

Case Study 1: Disorders of Fluid, Electrolyte, and Acid-Base Balance Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced that she was overweight because her clothes felt tight on her. She complained that even her hands and feet “were fat.” One of her nurses explained that a protein in her blood was low. The nurse further explained that, as difficult as it may be to believe, eating a normal healthy diet would make the “fat hands and feet” go away. What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema? What is the difference between the physiology of pitting and nonpitting edema? Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she was not on bed rest. How does this affect her edematous tissues?Disorders of Fluid, Electrolyte and Acid-Base Balance

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Disorders of Fluid, Electrolyte, and Acid-Base Balance

  1. What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema?
    The nurse was referring to the protein albumin being low. Reduced levels of albumin results in a decrese in the serum osmotic gradient (Darwish & Lui, 2019). Consequently, fluid exists from the capillaries to the adjacent extracellular surrounding, thus causing edema.Disorders of Fluid, Electrolyte and Acid-Base Balance
  2. What is the difference between the physiology of pitting and nonpitting edema?
    Pitting edema is caused by an elevated amount of extracellular fluid that go above the tissue gel’s absorption potential. with pitting edema (Whiting & McCready, 2016). The edema is movable and can be shifted under pressure. On the other hand, nonpitting edema comprises the movement of plasma proteins and capillary fluid into the interstitial space. The proteins coagulate and generate a solid edema that does not shift under pressure (Kakroo et al., 2020).
  3. Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she was not on bed rest. How does this affect her edematous tissues?

Edema results in an increased space between circulatory system and tissue cells which leads to the  tissue capillaries getting compressed. This indicates that the transfer of nutrients, wastes, and gases between capillaries and tissue cells and is significantly reduced (Kakroo et al., 2020). As such, tissues are left vulnerable to  pressure ulcers, and ischemic damage.

References

Darwish, A., & Lui, F. (2019). Physiology, Colloid Osmotic Pressure. In StatPearls [Internet]. StatPearls Publishing.

Kakroo, M. A., Vaitkevicius, P. V., & Baliga, R. R. (2020). Edema. In Practical Cardiology (pp. 39-46). Springer, Cham.

Whiting, E., & McCready, M. E. (2016). Pitting and non-pitting oedema. The Medical journal of Australia, 205(4), 157-158.Disorders of Fluid, Electrolyte and Acid-Base Balance