Acid-Base

Question 1

Metabolic acidosis

Answer 1

• diarrhea
• ESRD
• DKA

Question 2

Metabolic alkalosis

Answer 2

• vomiting
• gastric suctioning
• antacids
• hypokalemia (low potassium increases pH)

Question 3

Main cause of DKA

Answer 3

acute viral upper respiratory infection

Question 4

DKA s/s

Answer 4

• D
  
  • Dehydration
    
    • hypovolemic shock
    • tachycardia
• K
  
  • Ketones
  • Kussmals = abnormally deep
  • High K+
• A
  
  • Acidosis
  • Acetone breath
  • Anorexia d/t nausea
• Hyperglycemia

Question 5

DKA treatment

Answer 5

• Insulin IV (regular)
• IV fluids 200 ml/hr
• lower glucose by 50-75 mg/hr
• achieve normal MAP (70-100)

Question 6

compensated or uncompensated

Answer 6

• pH is between 7.35 and 7.45, it is compensated
• all three levels (pH, CO2, and HCO3-) are abnormal = partial compensation

Question 7

Acid-base regulation

Answer 7

• bicarbonate
  
  • raises pH level
  • IF GIVING BICARB, STOP NORMAL SALINE
• chloride
  
  • when given with bicarb, can cause hyperchloremic metabolic acidosis
• also extracellular fluid balance