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T Metabolic Acidosis
Metabolic Acidosis
| Question | Answer |
|---|---|
| What relationship exists between HCO3- and CL-? | inverse |
| What are the two main losses or gains that take the body into a state of metabolic acidosis? | loss of bicarbonate or gain of metabolic acids (or a combination ) |
| 2 ways to have too much H+ | increased production, decreased excretion |
| Name several ways to have too much metabolic acid (C, D, S, F, H, E, S, S) | Co2 poisoning, DKA, starvation, fever, hypoxia, ethanol ingestion, salicylate toxicity, sepsis |
| What could interfere with the elimination of metabolic acids? | Renal Failure |
| 2 ways to have too little bicarb | underproduction or increased elimination |
| Name 5 reasons for a shortage of Bicarb.(purld) | renal failure, pancreatitis, liver failure, dehydration, uremina |
| What effect would vomiting and diarrhea have on bicarbonate? | Increased elimination |
| Four symptoms of Metabolic acidosis from Ms. Fowler’s PPT (DKMC) | Disorientation, Kussmaul’s respirations, Muscle twitching, Changes In LOC |
| What is the cause of metabolic acidosis if the anion gap is greater than 14 mEq/L? | Metabolic acids |
| What type of acid is not considered a metabolic acid? | carbonic acid |
| What will the anion gap measurement look like if the cause of metabolic acidosis is a loss of bicarbonate? | normal – between 8 and 14 mEq/L |
| One way to have too much metabolic acid is the development of Ketones. What are ketones? | a metabolic by product of the catabolism of fatty acids when glucose supplies are depleted. |
| One way to have too much metabolic acid is the development of Ketones. Name 6 conditions that could put a patient in a state of Ketosis. (D, C,S, S, D, H, S, ) | Diabetes mellitus, chronic alcoholism, severe malnutrition or starvation, deficient carbohydrate intake, hyperthyroidism, severe infection with fever (hypermetabolic state) |
| What causes lactic acidosis? | Cells receive too little oxygen and are forced to metabolize glucose anaerobically which leads to lactate formation. |
| What conditions can lead to lactic acidosis? | conditions that cause metabolic demands to exceed oxygen supply such as shock, heart failure, pulmonary disease, hepatic disorders, seizures, or strenuous exercise |
| How would renal dysfunction contribute to metabolic acidosis? | decreased ability to excrete acids |
| What affect does hyperthyroidism have on metabolism? | speeds it up |
| What is the first manifestation of metabolic acidosis? | increased depth and rate of breathing/ Kussmaul’s respirations |
| Patients with what disorder may have fruity breath with kussmaul’s respirations? | diabetes – ketones |
| What are the CNS signs of metabolic acidosis in order of development? | lethargy, dull headache, confusion, stupor, coma |
| What happens to the cardiovascular system with metabolic acidosis? | Cardiac output and Bp drop, arrhythmias with hyperkalemia |
| What are the manifestations of metabolic acidosis on skin? | at first warm and dry due to peripheral vasodilation, but as shock develops; the skin becomes cold and clammy |
| What are the GI signs associated with metabolic acidosis? | VAN, Vomiting, Anorexia, Nausea |
| Uncompensated metabolic acidosis ABGs | pH low, PaCO2 normal, Bicarb low |
| Compensated metabolic acidosis ABGs | pH normal, PaCo2 low, Bicarb low |
| Why would potassium be high with metabolic acidosis? | excess H+ moves into cells and potassium moves out to maintain balance. |
| What lab values should be checked to see if our patient with metabolic acidosis has good liver function? (4) | BUN and Creatinine, HCT and HGB, |
| What might our patient receive by IV if their pH gets really low? | bicarbonate |
| What treatment will our diabetic patient with metabolic acidosis need ? What ion may become imbalanced with this treatment? | Fast acting insulin will move potassium into the cells and possible lead to hypokalemia. |
Created by:
Perseverandovercome
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