METABOLIC ALKALOSIS

Question 1

Cause

Answer 1

Vomiting and prolonged gastric suction (inc H production)

Question 2

Risk Factors

Answer 2

a. Diuretics
b. Excessive acid loss from GI tract

Question 3

Manifestation (DiDeCMuPaHHHNV)

Answer 3

a. Dizziness
b. Decreased LOC
c. Confusion
d. Muscle Twitching
e. Paresthesia
f. Headache
g. Hypocalcemia
h. Hypokalemia
i. Nausea and Vomiting

Question 4

Late sign (TeCo)

Answer 4

Tetany
Convulsions

Question 5

Overall Management (MASAMIC)

Answer 5

a. Maintain patent IV
b. Administer O2 as needed
c. Seizure precautions
d. Administer diluted potassium solutions with an infusion pump (hypokalemia)
e. Monitor I and O
f. Infuse ammonium chloride no faster than 1L over 4 hours
g. Carbonic Anhydrase Inhibitors (Diamox)

Question 6

Why should you administer ammonium chloride slowly?

Answer 6

To prevent hemolysis or RBC destruction

Question 7

Why is Diamox given?

Answer 7

Increases renal excretion of HCO3