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Metabolic Acidosis

Metabolic Acidosis;

QuestionAnswer
Metabolic acidosis is generally caused by overproduction/underelimination of hydrogen or overelimination/underproduction of bicarbonate
Overproduction of hydrogen includes excessive breakdown of fatty acids, lactic acidosis, and excessive intake of acids
Fatty acid breakdown occurs in starvation and diabetic ketoacidosis
Lactic acidosis anerobic glucose breakdown, occurs in heavy exercise, seizures, and reduced oxygen intake
Underelimination of hydrogen includes Kidney and respiratory failure
Overelimination of bicarbonate includes Bicarbonates are excreted too quickly, as in diarrhea
Underproductoin of bicarbonate includes Kidney and pancreatic failure
Other underlying causes of metabolic acidosis hyperthyroidism, infection, burns, circulatory shock, tissue anoxia, oliguric, renal failure, intake of acids (aspirin), GI fistual drainage, GI and pancreatic secretions, intestinal decompression, renal tubular acidosis, DM, sepsis, and anorexia
Metabolic acidosis cardiovascular s/s inc HR or cardiac output, signs of hyperkalemia includes dec HR, T waves peaked, QRS complex widened, hypotension, thready pulse
Metabolic acidosis CNS s/s depressed or unresponsive
Metabolic acidosis neruomuscular s/s hyporeflexia, skeletal muscle weakness, flaccid paralysis
Metabolic acidosis respiratory s/s kussmaul (deep, rapid, involuntary) respirations, varied respirations
Metabolic acidosis integumentary s/s warm, flushed, dry skin
What is one of the first signs of acidosis? Behavioral changes
Hypokalemia in metabolic acidosis weak pulse, depressed U waves, shallow respirations and SOB
What should be done for metabolic acidic pt with hypokalemia? verify renal function before administration of K, do not give K too rapidly, dilute K, give with orange, grape, tomato or apple juice--Vitamin C/ascorbic acid helps K absorption
Other disorders that appear with metabolic acidosis DM, hypovalemia, renal failure, lactic acidosis, addison's dz.
Care for diabetes mellitus in metabolic acidosis admin insulin when hyperglycemic, admin glucose with hypoglycemic, insulin can help in uptake of K
Care for hypovalemia in metabolic acidosis volume expander, blood transfusions, monitor and treat shock
Care for renal failure in metabolic acidosis Dialysis, transplant, dietary modifications (control of protein, Na, fluid, supplemental calories and carbs needed)
Lactic acidosis Oxygen and NaHCO3 (sodium bicarbonate)
Addison's D. cortisone preperations, high sodium diet, fluids for shock
Created by: kalensnyder