Metabolic Alkalosis

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

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

Metabolic Alkalosis

accumulation of HCO3 or decrease in H+ concentration *if left untreated can cause cardiac arrhythmia, coma, or death

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

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)

*Metabolic Alkalosis*

*increased pH *Increased HCO3

Diagnostic Findings

ABGs (increased pH and HCO3) decreased respirations (shallow breathing) to hold CO2 hypokalemia urine chloride