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Friday, February 13, 2015

Metabolic Alkalosis Study Guide

Metabolic Alkalosis, acid-base imbalance, vomiting, suction, antacids, pH, bicarb

Metabolic Alkalosis Study Guide

Metabolic Alkalosis is another acid-base imbalance. In this imbalance there is a high pH and a high bicarbonate concentration. It can happen from a gain in bicarb or a loss of hydrogen ions. This post will cover the causes, signs and symptoms, and treatments of metabolic alkalosis.


Metabolic Alkalosis is a pH above 7.45 and a bicarb above 26. The norm for pH is 7.35-7.45. The norm for HCO3 is 22-26.

This is the third post in a five post series on acid-base imbalances. So if you haven't check them out you might want to look at these posts first, then pop back onto this post.

ABGs: The Ultimate Beginners Guide
Metabolic Acidosis
Respiratory Acidosis
Respiratory Alkalosis

Ok. Here's a chart for a quick review:

ROME: Respiratory Opposite. Metabolic Equal.

Remember Metabolic Acidosis is from the ass (diarrhea). Just think, it puts the ass in acidosis. Hey, whatever helps me remember things, right?

Metabolic Alkalosis is from the mouth (vomiting)

Don't you love my inappropriate humor?? ;)

ABGs, Arterial Blood Gases, nurse, lab draws, respiratory alkalosis, respiratory acidosis, metabolic alkalosis, metabolic acidosis, pH, Acid-Base Imbalances

Causes


  • Vomiting/ Gastric Suction- This is important to monitor
  • Hypokalemia
  • Hyperaldosteronism
  • Cushing's
  • Ingesting too much alkali (such as antacids)
  • Potassium- losing diuretics (because this causes hypokalemia-- thiazides, furosemide, ethacrynic acid)

Signs and Symptoms



  • Dizziness
  • Tingling- fingers and toes
  • Depressed respirations- compensatory mechanism
  • Headache
  • Confusion
  • Lethargy
  • Arrhythmia- typically as tachycardia
These symptoms can often be similar to hypocalcemia because ionized calcium is decreasing by combining with proteins in alkalosis. Potassium can also be low (< 3.5) because of alkalosis.

Treatment


Like everything, it matters what the cause of the alkalosis is so that you can properly treat it. Administer 0.9% Normal Saline and supplement low potassium levels. Chances are potassium is low and chloride can be low from vomiting-- thus the treatment. If it's caused by the patient's diuretic, you might consider switching prescriptions.

Ok. Have fun kids!

I didn't go into too many details on this post, so if you'd like more information I have an ebook on for $3.99 that explains everything so much better. I also work through practice problems with you- step by step. I know how confusing this can be. It took me four different teachers, and four different classes until I FINALLY learned acid-base imbalances the correct way. So check it out! Easy Guide to Interpret Acid-Base Imbalances. It's cheaper than your lunch, and you don't even need to have a kindle to read it!! Thanks!!

Is there anything that you're struggling with in school that you'd like for me to discuss??? Leave a comment below!!

Xoxo,
Nightingale

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