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8 terms

Metabolic Alkalosis

NUR 105 Med/Surg Acid Base Balance
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Metabolic Alkalosis
*increased pH
*Increased HCO3
Metabolic Alkalosis
accumulation of HCO3
or
decrease in H+ concentration
*if left untreated can cause cardiac arrhythmia, coma, or death
Major Causes
vomiting or gastric suction; loss of hydrochloric acid from stomach
loss of K
excess alkali ingested from antacids(containing HCO3)
use of Sodium Bicarbonate during CPR
Signs & Symptoms
mostly related to movement of Ca (decreased Ca ionization)
tingling of fingers and toes
dizziness
carpopedal spasm (Trousseau sign)
depressed respirations (b/c of compensation trying to hold CO2)
paralytic ileus (gut shuts down to hold HCO3)
Diagnostic Findings
ABGs (increased pH and HCO3)
decreased respirations (shallow breathing) to hold CO2
hypokalemia
urine chloride
Medical Management
eliminate the cause (too much bicarb, to much loss of acid)
use antiemetics, H2 blockers
correct electrolyte imbalances
give calcium gluconate
correct fluid volume depletion
Calcium Gluconate
give to patient to correct calcium imbalance in patient with carpopedal spasms or tingling fingers/toes
In a patient with metabolic alkalosis you will see...
restlessness, followed by lethargy
dysrhythmias
compensatory hypoventilation
diarrhea
confusion, decreased LOC
nausea and *Profuse vomiting
slow respirations
hypokalemia
increased pH
increased HCO3