Metabolic Alkalosis

Question 1

If you have Metabolic Alkalosis, what ABG values are going to be abnormal?

Answer 1

pH is abnormally high

HCo3 is abnormally high

Question 2

If you have Metabolic Alkalosis with respiratory compensation, what ABG values are going to be abnormal?

Answer 2

pH is abnormally high

HCo3 is abnormally high

pCO2 is abnormally high

Question 3

What are the causes of Metabolic Alkalosis?

Answer 3

Excess H+ loss via upper GI loss:
Vomiting
Gastric suction

Excess bicarbonate intake:
Antacids
Parenteral (IV) Na HCO3

Potassium-Wasting Diuretics / Loop Diuretics (Furosemide)

Question 4

What are the clinical manifestations of Metabolic Alkalosis?

Answer 4

Tachycardia, hypotension, confusion, muscle weakness, Dizziness, tetany, Ineffective breathing

Paresthesias: Numbness, tingling of extremities

Question 5

What part about Metabolic Alkalosis can cause Tetany and Muscle Weakness?

Answer 5

Hypokalemia

Question 6

How does the body compensate for Metabolic Alkalosis?

Answer 6

Buffer system: attempts to make weak base

Respiratory Compensation – Retain CO2
Respiratory rate = Slows & shallow to retain CO2

Renal: Excrete bicarbonate & retain H+

Question 7

What are the nursing actions for Metabolic Alkalosis?

Answer 7

Treat the underlying cause:

Stop Vomiting

Limit NG Tube suctioning as much as possible + Try to get it corrected asap

Investigate the overuse of Na HCO3