She becomes the fifth hokage.
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because technically she is kined to Naruto because Mito Uzumaki is Tsunade's grandmother
because tsunade sent jiraiya on mission
right now as naruto is being trained by jiraiya and sakura by tsunade they really can't have a naruto show without the main character naruto so between the time skip of naruto's training they are turning naruto shippuden(when they are older) into English
She has called Tsunade: Tsunade-sama (Lady Tsunade), Hokage-sama, Godaime Hokage-sama (5th Hokage), and Shishou. (master)
=No, but naruto calls her grandma tsunade just to annoy her.=