Metabolic Alkalosis Case Study

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The case is about a 22-year-old female who has been sick for eight days. She thought that she had the “Flu”. She complained of nausea, vomiting and had a poor appetite. To counteract her nausea, she was taking copious amounts of antacids. She fell at home and was taken to the ER. She was dehydrated and intravenous fluids were given to rehydrate her. An arterial blood gas (ABG) was drawn. The results of the ABG showed an acid-base disturbance.
The patient’s acid-base disturbance was acute metabolic alkalosis. This is the most common disturbance in hospitalized patients (Thomas, 2016a). This was based on her arterial blood gas (ABG) results as well as the patient’s clinical presentation. Her pH was 7.5 (normal range 7.35- 7.45) which indicated
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There are two types of acute metabolic alkalosis and relates to the amount of chloride in the urine. Chloride-responsive is when the chloride level in the urine is less than 10meq/L and is mostly due to vomiting and dehydration. Chloride-resistant is when the urine chloride level in the urine is greater than 25 meq/L and is usually caused by antacids and other conditions (Thomas, 2016b). She had nausea and vomiting for many days and was taking an unknown type of antacid. Another ABG, complete metabolic profile (CMP), complete blood count (CBC) with differential, urine electrolytes and urinalysis should have been obtained to evaluate the patient’s status and what further treatment was needed. Some antacids contain sodium bicarbonate (Alka-Seltzer) so that could have contributed to the acid-base disturbance (Kahn & Cherney. 2017). Since she was dehydrated and vomiting, contraction alkalosis occurred. This is when hydrochloric acid (HCL) is reduced in the stomach and the body tries to compensate by releasing aldosterone and then reabsorbs HCO3 into the blood (Lewis, 2016). If the condition is not treated the respiratory and renal systems will try to compensate for the acid-base …show more content…
The patient was vomiting for many days and did not seek medical assistance. If the patient is vomiting for more than twenty-four hours, have symptoms of dry mouth, syncope, decreased urination and dark urine it is important to seek medical assistance and get treated. It is important to educate them about eating a good diet, staying healthy and keep themselves hydrated. Maintaining hydration (unless you have a medical condition) and eating foods high in nutrients and potassium can prevent alkalosis (“Alkalosis,” n.p.). I would provide the patient (in their language) with information on dehydration that includes causes, daily requirements, symptoms, tips to stay hydrated and when to call for assistance. Education is critical in preventing an acid-base

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