ARBs: Acute and Chronic Metabolic ALKALOSIS (Base Bicarbonate Excess)

Question 1

Metabolic Alkalosis

Metabolic Alkalosis can occur due to __?__(2)

Answer 1

1. High pH loss of H ions
2. Gain of bicarbonate

Question 2

Metabolic Alkalosis

Common cause of metabolic alkalosis is (3) examples

Answer 2

1. Volume depletion from vomitting
2. gastric suction
3. Pyloric stenosis if gastric fluid is loss

Question 3

Metabolic Alkalosis

1. Loss of the electrolyte can cause of metabolic alkalosis?
2. Loss of this electrolyte by ___?___therapy promotes excretion…name two medications that cause this?

Answer 3

1. Potassium cation
2. Diuretic Therapy, Thiazides, Furosemide

Question 4

Metabolic Alkalosis

1. Excessive adrenocorticoid hormone cause by (2) conditions also results in increase excretion of K

Answer 4

1. Hyperaldosteronism
2. Cushing’s Syndrome

Examples of adrenocortical hormones that are involved in the stress response are** aldosterone **and cortisol. These hormones also function in regulating the conservation of water by the kidneys and glucose metabolism, respectively.[1]

Question 5

Metabolic Alkalosis

Hypokalemia produces alkalosis in two ways?

Answer 5

1. Kidneys conserve potassium and H excretion increases
2. Cellular K moves out of cells in ECF
3. decreased K to alkalsosis is al-K-low-sis

Question 6

Chvostek and Trousseau

1. Metabolic Alkalosis s/s are primarily related to decrease in what electrolyte?
2. Name s/s (9)

Answer 6

1. Ca hypocalemia
2. Tingling of fingers and toes
3. dizziness
4. Hypertonic muscles
5. Positive Chvostek twitching of the check (C for Chvostek)
6. Positive Trousseau sign: Carpal spasm of hand develops when BP cuff is inflated above systolic pressure for several minutes
7. Laryngospasm
8. Dysrhythmias
9. Often Hypomagnesemia occurs

Question 7

Carbonic anhydrase inhibitors

Nursing Management

Answer 7

1. Correct underlying cause
2. Monitor I/O
3. Restore normal flulid vol via NaCl fluids
4. Heart Failure patient often cannot tolerate rapid vol expansion tx with Carbonic anhydrase inhibitors