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22 Cards in this Set
- Front
- Back
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What is metabolic alkalosis?
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Metabolic alkalosis is a bicarbonate excess characterized by a high pH (>7.45) and a high bicarbonate (>26) it may be caused by loss of acid or excess bicarbonate in the body. When metabolic alkalosis develops, the respiratory systems attempts to return the pH to normal by slowing the respiratory rate. carbon dioxide is retained & the PaCO2 increases (>45).
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How can Hydrogen ions be lost?
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Through the kidneys or via gastric secretions or bc shift of H+ into the cells.
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Metaboli alkalosis due to loss of hydrogen ions usually occurs b/c __________.
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of vomiting & gastric suction. Gastric secretions are highly acidic (1-3). When these are lost through vomiting & gastric sunctioning , the alkalinity of body fluids increases. This increased alkalinity results from lost of acid & from selective retention of bicarbonate by the kidneys as chloride is depleted.
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Chloride is the major anion in ECF; when it is lost____________.
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bicarbonate is retained as a replacement anion.
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Increased renal excretion of hydrogen ions can be propmted by hypokalemia s the kidneys try to conserve potassium excreting what instead?
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Hydrogen ion
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Excess bicarbonate usually occurs as a result to what?
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ingesting antacids that contain bicarbonate (such as soda bicarbonate or Alka-Seltzer) or overzealously administering bicarbonate to treat metabolic acidosis.
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What accounts for many manifestations of metabolic acidosis?
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In alkalosis, more calcium combines w/ serum proteins , reducing the amount of ionized (physiologically active) calcium in the blood . This accounts for many manifestations of metabolic acidosis.
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Alkalosis affects potassium balance:
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Hypokalemia not only can cause metabolic alkalosis, but can result from metabolic alkalosis.
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What are the risk factors for metabolic Alkalosis?
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-Hospitalizations
-Hypokalemia -Treatment w/ alkalinizing solutions (bicarbonates) |
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What are some clinical manifestations of Metabolic Alkalosis?
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Manifestations of Metabolic Alkalosis occurs a result of decreased calcium & are similar to those of hypocalcemia.
-Numbness & tingling around the mouth, fingers , & toes -Dizzininess -Trousseau's sign -Muscle Spasm As the respiratory system compensates for metabolic alkalosis, respirations are depressed and respiratory failure w/ hypoxemia & respiratory acidosis may develop. |
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What are pharmacological Therapies of Metabolic Alkalosis?
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-Restore Fluid Volume & administer potassium chloride & sodium chloride solution.
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What does the potassium restore?
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The potassium restores serum and intracellular potassium levels , allowing the kidneys to conserve hydrogen ions more effectively.
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What does the Chloride do?
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Chloride promotes renal excretion of bicarbonate.
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What do Sodium Chloride do?
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Sodium Chloride solutions restore fluid volume deficits that can contribute to metabolic alkalosis.
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in severe alkalosis, a acidifying solution such as dilute hydrochloric acid or ammonium chloride may be administered.
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In addition, drugs may be used to treat the underlying cause of the alkalosis.
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Labs & Diagnostic test for Metabolic Alkalosis
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-ABGS
-Serum electrolytes -Urine Ph -ECG pattern |
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Abgs
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ph > 7.45 & HCO3 >26 with a compensatory hypoventilation , CO2 is retained & CO2 is greater than 45
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Serum Electrolytes
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-Decreased serum Potassium (<3.5)
-Decreased chloride (<95) Serum HCO3 is high. -Although serum calcium high, Ionized Calcium low |
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Urine ph
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-Low (pH 1-3) if metabolic acidosis is caused by hypokalemia. The kidneys selectively retain potassium & excrete Hdrogen ions to restore ECF potaassium levels. Urinary chloride levels may be normal or greater than 250mEq/24hr
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ECG pattern
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show those similar to hypokalemia. these changes maybe due to hypokalemia or to the alkalosis.
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Diagnosis of metabolic Alkalosis
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Risk for impaired Gas Exchange
Deficient Fluid Volume Risk for Injury Knowledge Deficit |
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Plan for metabolic Alkalosis
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-Return to oxygen saturation level of 95% or greater
-Return to normal or near normal fluid & electrolyte volumes |
