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28 terms

Metabolic acidosis and alkalosis

Therapeutics exam 1 fluid disorders
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caused by methanol and ethylene glycol intoxication
metabolic acidosis (increased anion gap)
patients with this present with high anion gap metabolic acidosis, severe acidemia, hyperglycemia, ECF depletion, seemingly normal potassium
DKA
this is a high anion gap metabolic acidosis that can occur when the GFR declines below 20% of normal
uremic acidosis
respiratory compensation for metabolic acidosis
increased ventilation which produces a secondary decrease in PCO2
treatment of DKA
insulin, saline, potassium
impact of ECF depletion on acid-base status
causes increased renal retention of HCO3-
patients with metabolic alkalosis due to ECF depletion respond to this
NS
amount of chloride in urine in someone with saline-responsive metabolic alkalosis
less than 10
acid-base disorder caused by vomiting
metabolic alkalosis
acid-base disorder caused by profound potassium depletion
metabolic alkalosis
acid-base disorder caused by diarrhea
metabolic acidosis
respiratory compensation for metabolic alkalosis
decreased ventilation which produces a secondary increase in PCO2
normal anion gap
9-16
meaning of low pH (less than 7.35)
either metabolic or respiratory acidosis
low pH and low HCO3-
metabolic acidosis
low pH and high PCO2
respiratory acidosis
high pH (more than 7.45)
either metabolic or respiratory alkalosis
high pH and high HCO3-
metabolic alkalosis
high pH and low PCO2
respiratory alkalosis
faster compensation mechanism--lungs or kidneys?
lungs
starting treatment for DKA
NS
give this after NS for DKA
insulin
type of alkalosis with a urine chloride < 10
saline responsive
type of alkalosis with a urine chloride > 20
saline resistant
excessive diuretics, vomiting, CF cause this type of metabolic alkalosis
saline responsive
excess mineralcorticoid activity causes this type of metabolic alkalosis
saline resistant
treatment for metabolic alkalosis with low BP
NS
must treat this first in metabolic alkalosis
underlying cause (vomiting-->anti-emetics)