Considering the case study, the pathophysiology of metabolic alkalosis is common and generally occurs when bicarbonate is increased. This is caused by excessive loss of metabolic acids especially on excessive vomiting. Acid loss is because of vomiting due to lowering of extra fluid outside the cell together with chloride ions. Consequently, renal replenishment is not very effective. This is because the body may try to return such an imbalance to normalcy but the level of bicarbonate and carbon dioxide will remain destabilized (Lehne, 2012). In this case, study, metabolic alkalosis causes a HCO3 to shift above 26 meq/L with a pH above 7.45 but Paco2 remains normal.
Additionally, the release of hydrogen ions causes an increase in sodium and bicarbonates retake by the kidney. The role of Bicarbonate is to maintain an anionic balance. This is because the chloride ions in the fluid outside the cell are decreased significantly. Due to decreased concentration of potassium, hydrogen ion moves to space outside the cell to maintain an electrochemical balance. Fluids excreted outside the cells and organ like kidney remain acidic (Lehne, 2010). However, this fluid outside the cell can be returned to normalcy with a mix of sodium chloride and potassium ("Acidosis and Alkalosis: Acid Base Disorders," 2012).