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What is Metabolic Acidosis?
- -any process that lowers plasma [HCO3]
- - reduced [HCO3] decreases blood pH (less amount of base relative to the amount of acid in the blood)
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What causes Metabolic Acidosis?
- 1. fixed acid (nonvolatile) accumulation
- 2. An excessive loss of HCO3 from the body
- ***Analysis of the plasma electrolytes (anion gap) is helpful in differentiating the metabolic acidosis cause by a fixed acid gain from that caused by a loss of base.
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What is an Anion Gap?
The law of electroneutrality states that the total number of positive (+) charges must equal the total number of negative (�) charges in the body fluids
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What are the normal values for cation plasma electrolytes?
- Na+ = 140 mEq/L
- K+ = 5 mEq/L
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What are the normal values for anion plasma electrolytes?
- Cl- = 105 mEq/L
- HCO3- = 24 mEq/L
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Which is normally more prevalent in plasma, cations or anions?
Cations
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What is the gap between cations and anions reffered to as?
anion gap
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What is the normal range for Anion Gap?
9 to 14 mEq/L
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What does an Anion Gap > 14 mEq/L indicate?
metabolic acidosis in which fixed acids accumulate in the body
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What is the cause of Metabolic Acidosis?
- hyperchloremic acidosis = increase Cl- (loss of HCO3-), but with normal anion gap
- - e.g. diarrhea
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What are some symptoms of Metabolic Acidosis?
- - increased Vt
- - hypernea (increased depth of Vt)
- - Kussmaul's respiration (very deep, gasping)
- - lethargy to coma (severe type of Metabolic Acidosis)
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What are some possible corrections for Metabolic Acidosis?
- - respiratory compensation to raise pH above 7.20
- - treatment of underlying cause of acid gain or base lose
- - intravenous infusion NaHCO3 may be indicated for severe metabolic acidosis
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What are the causes of Metabolic Alkalosis?
- 1. Loss of fixed acids (nonvolatile)
- 2. Excessive gain of buffer base
- e.g. vomiting (causes loss of HCl), nasal gastric drainage, diuretics, state of hypochloremia, hypovolemia, and alot of bicarbonate present
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What is Primary active transport?
a method in which sodium is reabsorbed out from the renal tubule cell into the blood
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What is Secondary active secretions of H+ and K+?
done by the kidney allows for exchange of Na+ (reabsorption of Na+)
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When a patient has Metabolic Alkalosis that resulted from use of diuretics, low-salt diets, and gastric drainage, the term used is?
iatrogenic
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