5) Explain the cause of her elevated ADH and glucoselevels.
Elevated ADH may be caused by the disease known as SIADH whichis the syndrome of inappropriate ADH. Furthermore, the presence oflung carcinoma can also account for the elevated ADH; the patientshows a history of smoking. There is a history of diabetes mellitusso that glucose levels will be increased due to insulin deficiency.The glucose level is elevated due to the patient's response toinsulin and glucose utilization is impaired. Antidiuretic hormoneis elevated because of the dilution. In diabetes mellitus, the flowof urine is increased, as such fluid movement in the body isaccelerated because of the glucose- triggered or induced an osmoticdiuresis or water loss. (Calhoun, 2017) On the other hand, plasmavasopressin (VP) is elevated in both type 1 and type 2 DM. Thiselevation seems to be due to a resetting of the osmostat. A high VPlevel is beneficial in the short term because it limits to someextent the amount of water required for the excretion of a markedlyenhanced load of osmoles (mainly glucose). However, in the longrun, it may have adverse effects by favoring the development ofdiabetic nephropathy.
6) What is the correlation between her illnesses and the lowvitamins (D, K, E, and A), renin, and aldosterone levels?
Low levels of renin results in hypotension. Renin plays avital role in activation of angiotensinogen to angiotensin II, avasoconstrictor which is needed for maintenance of blood pressure.As a result of reduced or low levels of renin, she has hypotension.(Calhoun, 2017)
The hormone aldosterone triggers the kidneys to reabsorbsodium. Low levels of aldosterone results in a reduced level ofsodium (hyponatremia) in the body.
The elevated levels of ADH result in high rate of retention ofwater which occurs in low sodium level in blood. This isresponsible for bilateral edema.
The patient’s physical assessment reveals that she has skindiscoloration possible jaundice, yellowish sclera, and multiplebruises. This is as a result of the deficiency of or low vitamin A.Furthermore; the patient lab values shows hypocalcemia; this may beas a result of lack of vitamin D as earlier discussed which isuseful and vital in the absorption of calcium from the intestine.(Albert, 2013) Low levels of calcium can also be associated withVitamin K deficiency also because of blood clotting factorfunctions based on the calcium level in the body.
The patient’s weakness may be associated with vitamin Edeficiency. The absence of vitamin E can be problematic to the bodyas it is an excellent and vital antioxidant needed in thebody
7) Which hormone would the body elevate in response to her lowcalcium levels? Why
There is a low level of calcium in the body. The level ofcalcium can be regulated and controlled by parathyroid hormone(PTH) (Calhoun, 2017). This hormone helps in decalcification ofbones that triggers the release of calcium into blood, t as suchincreasing reabsorption of calcium in the kidneys. The parathyroidhormone will be elevated or high in response to low calcium levels.This is because parathyroid hormone increases phosphate excretionand increases serum calcium by increasing renal calciumreabsorption. (Silverthorn, 2019)
8) Explain the physiological reason behind her physicalfindings (yellowish of the skin, sclera, multiple bruises,weakness, and edema).
Jaundice is referred to as discoloration of the skin; itpresents itself as yellowish skin, mucous membrane, and sclera.Resulting from high or increased levels of bilirubin in theblood.
Yellowish discoloration of skin, sclera - it is suggestive oficterus. Icterus is a condition caused by hyperbilirubinemia. Thepresence of this suggests liver pathology.
Skin bruises - this may be due to Vitamin A deficiency orinadequacy as Vitamin A helps in maintaining the integrity of theskin. (Silverthorn, 2019)
Weakness could be as a result of anemia. Weakness is one ofthe significant symptoms of weakness, and also weakness could be aresult of low levels or decreased Vitamin E.
Edema - Aldosterone, and renin play a significant role inedema. Edema is most of the time caused by excessive retention ofsalt and water in the body. Increased ADH and decreased levels ofRenin and Aldosterone can affect the body and cause it toswell
9) Explain the cause of her abnormal stool and urinesample.
There is insufficient excretion of the bilirubin from theliver, due to some obstruction. Due to the inadequate excretioncolors of our excreted waste products can change in color. Theregular brown color of stool is due to an excretory product ofbilirubin, called stercobilin, which is metabolized frombilirubin.
The fat in the stool may also be due to the bile obstructionor gallbladder malfunction. The regular yellow color of urine is asa result of the urobilinogen, which is also an excretory product ofbilirubin, as the bilirubin excretion is decreased, the color ofoutput will change. (Silverthorn, 2019)
10) What cell does Glisten work on? Explain how thismedication can stimulate insulin secretion
Glisten work on the beta cells of the pancreas. Beta cellssecrete insulin which increases glucose metabolism while alphacells release glucagon. The secretion of insulin is an ionic andelectrical event in the membrane. Of the beta cell. If there i noglucose, membrane potential remains stable (-65mV). ATP from theglucose metabolism blocks or closes the K+ ion channels in themembrane. Therefore, more the glucose, more will be the closure ofK+ ion channels.
The decreased permeability of K+ ions in the cell will causedepolarization and opening of voltage-gated Ca2+ ion channelopening.
Glisten also function by closing the ATP dependent K+ionchannels to close, as such inducing the release or let out ofinsulin from the beta cells.
