Wait a second!
More handpicked essays just for you.
More handpicked essays just for you.
metabolic acidosis
Don’t take our word for it - see why 10 million students trust us with their essay needs.
Recommended: metabolic acidosis
Acid-base Imbalance Case Study Acid-base imbalances are seen in the emergency room daily. The ability to diagnose and treat depends on determining the patients underlying cause and understanding how to treat it. A 22 year old women has been presented in the emergency room with flu-like symptoms, excessive vomiting, unable to tolerate food, and taking high doses of antacids for eight days (GCU, 2010). Arterial blood gases and IV fluid have been started. The following paper will analyze the blood results to determine the acid-base disturbance, pathophysiologic factors that lead to this imbalance, how the body compensates, pharmacology intervention, and patient education.
Classifying Patient Acid-base Disturbance In classifying this patient’s
The most common cause of metabolic alkalosis is an increase of pH and an increase in HCO3 (Lehne, 2013). This occurs as the body loses hydrogen ions. Hydrogen ions are rich in the gastric secretions which is lost when a person is continually vomiting. When the hydrogen ions are excreted, a bicarbonate ion is gained in that extracellular space causing a buildup in the stomach. It continues to manifest as alkalemia (pH> 7.40). The body’s compensatory mechanism tries to stabilize bicarbonate levels. This leads to alveolar hypoventilation with a rise in arterial carbon dioxide tension (PaCO2) and diminishes the changes in pH that would normally occur (Lehne, 2013). Ingestion of large amounts of non-absorbable antacids can also generate metabolic alkalosis. “When magnesium hydroxide, calcium or aluminum with a base hydroxide or carbonate, the hydroxide anion buffers hydrogen ions in the stomach” (Schreiber, 2013).The cation binds to the bicarbonate that is secreted by the pancreas and is excreted out of the body. In a normal functioning body, both hydrogen ions and bicarbonate are loss without any acid-base disturbances. When there is an increase of sodium bicarbonate, they do not bind with the cation and are reabsorbed causing an imbalance (Schreiber, 2013). Sodium bicarbonate amounts exceed the capacity of the kidneys and cause
Antiemetics would be administered to reduce vomiting. 0.9% normal saline at 50-100 ml rate would be given to correct fluid losses. If continuous gastric suction is necessary, an H2 blocker or PPI would be added to decrease gastric secretions and let the stomach rest. Supplements with potassium would be given to prevent hypokalemia from volume resuscitation. Labs to monitor electrolytes in the blood and urine would be done. Vital signs to monitor blood pressure, pulse, respirations, oxygen levels, and temperature for any dynamic
A 54 year old female was presented with complaints of lethargy, excessive thirst and diminished appetite. Given the fact that these symptoms are very broad and could be the underlying cause of various diseases, the physician decided to order a urinalysis by cystoscope; a comprehensive diagnostic chemistry panel; and a CBC with differential, to acquire a better understanding on his patient health status. The following abnormal results caught the physician’s attention:
Once the paramedics retrieve Marc, he will have a high concentration of salt in his blood and fluids. This means that the paramedics would treat him with the half normal saline. This is the solution with the lowest percentage of solutes (0.45% NaCl).this will increase his concentration of water throughout this body and will return his cells to their normal size. However, if the paramedics were to keep him on the half normal saline for too long, his water concentration would be too high and his solute concentration would become too low. This would mean that the paramedics would then need to switch Marc to the normal isotonic saline solution (0.9% NaCl). This would balance out both the concentration of water and solutes so that they are now equal. This would set his balance and homeostasis back to normal, thereby helping his recovery. (Johnson
This health care team have to make sure that this patient have normal GI functioning, and they have to make sure that this resident pass gas or they can check for bowel sounds to make sure that this person is ready to make the transition before he can start enteral feeding (DeBruyne & Pinna, 2012). As soon as this person starts with oral feeding, Clear liquid diet will be given first, then gradually the intestine will able to accept solid food. Once the patient is able to consume enough nutrients, then parenteral feeding will be discontinued (DeBruyne & Pinna,
Diabetic Ketoacidosis (DKA) is a serious disease with complications that may have fatal results in some cases. DKA is defined as an insulin deficiency that occurs when glucose fails to enter insulin into muscles such as: liver and adipose tissue. When there is an accumulation of ketones, it leads to metabolic acidosis which causes nausea and vomiting, as a result fluid and electrolytes are loss (Gibbs). There are many complications of diabetic ketoacidosis, some of the most prevalent are: Cerebral Edema, Hypolglycemia, and Acute Pancreatitis.
In the adult intensive care unit, the patients who are mechanically ventilated with a need for enteral nutrition will be the population in question. The intervention is the use of small bowel enteral feedings, and the control is the feeding route via a gastric tube. The intervention and the control are the two aspects one wishes to compare. The outcome in question is decreased aspiration of enteral feedings. The research question can be stated as the following: In the adult intensive care unit, with ages ranging from 18-89 years, intubated and mechanically ventilated critically ill patients who require enteral nutrition will have a decreased risk for aspiration with the implementation of small bowel enteral nutrition compared to gastric enteral
Diabetic Ketoacidosis (DKA) is a serious disease with complications that may have fatal results in some cases. DKA is defined as an insulin deficiency that occurs when glucose fails to enter insulin into muscles such as: liver and adipose tissue. When there is an accumulation of ketones, it leads to metabolic acidosis which causes nausea and vomiting, as a result fluid and electrolytes are lost (Gibbs). There are many complications of diabetic ketoacidosis, some of the most prevalent are: Cerebral Edema, Hypoglycemia, and Acute Pancreatitis.
Like with anything else, it is imperative to ensure a patent airway, adequate ventilation, good oxygenation, and adequate circulation. However, stroke patients have an increased risk of losing the ability to protect their own airway and subsequently aspirate. You can help protect the patient from aspirating by simply placing them in the semi-fowlers position. Now if severe vomiting becomes a factor and the airway is compromised, intubation may need to be used to protect the patient from any further aspiration. If either the tidal volume or rate becomes inadequate, quickly assist their ventilations at a rate of 10-12 breaths per minute. If assistance is needed with ventilations, its good practice to have your BVM hooked up to oxygen too because unless your patient is intubated at this point, some of the room air you pump into them is going to go into the stomach, making for less adequate oxygenation. Along with the ABC component, you’re going to establish IV access and apply the cardiac monitor to see what the heart is doing (Mistovich, 2008). Treating the symptoms is all you’re going to be able to do. As it was mentioned before, the only way to treat the underlying problem is to get the patient to the hospital as quickly as you
The patient is a 55-year-old man admitted to the hospital for dehydration secondary to vomiting. The physical examination of the patient revealed dry mucous membranes and vital signs as follows: Pulse 110, blood pressure 100/60, and respirations of 20.
The most important elements of the guidelines are organized into two “bundles” of care (Angus, 2013). The first “bundle” is for within the first 3 hours sepsis is suspected. The first thing you would do is measure the lactate level. The second thing is obtaining blood cultures prior to administration of prescribed antibiotics. You administer broad spectrum antibiotics in patients with septic shock. The risk of dying increases by approximately 10% for every hour of delay in receiving antibiotics. The last thing you would do for the 3 hr “bundle” is fluid resuscitation: administer 30 mL/kg crystalloid for hypotension or lactate ≥ 4mmol/L (Subtle Signs of Sepsis, 2017). The second “bundle” is for within the first 6 hours sepsis is suspected. The nurse would do the same protocol for suspected sepsis within 3 hours and continue for more advanced treatment. The next thing you would do is administer vasopressors (for hypotension that does not respond to initial fluid resuscitation) to maintain a MAP ≥ 65 mmHg. For persistent arterial hypotension despite volume resuscitation (septic shock) or initial lactate ≥ 4 mmol/L (36 mg/dL), reassess volume status and tissue perfusion and document findings. After initial fluid resuscitation, repeat focused exam, including pulse, capillary refills, vital signs, cardiopulmonary assessment, and skin (Subtle Signs of Sepsis,
Seron-Arbeloa, C., Zamora-Elson, M., Labarta-Monzon, L., & Mallor-Bonet, T. (2013). Enteral nutrition in critical care. Journal of Clinical Medicine Research, 5(1), 1-11. doi:10.4021/jocmr1210w
Mental illness has been a condition that results in affecting a person aspect of life. However, some people who develop a mental illness may experience one episode in their life and recover completely; consequently, others may have repeated episodes of the illness. Therefore, this condition can cause severe disability. As we know mental disorders are brain disorders. Research has proven that the condition is related to chemical imbalance. Chemical imbalance is the production of maximum or minimum hormones, enzymes and neurotransmitters stimulation in the brain. The neurotransmitters send chemical messages between the neurons. Mental disorders, such as anxiety, mood, post-traumatic stress,
Alveolar hyperventilation causes a decreased partial pressure of arterial carbon dioxide (PaCO2). The decrease in PaCO2 increases the ratio of bicarbonate concentration to PaCO2 which increases the pH level. The decrease in PaCO2 develops when a strong respiratory stimulus causes the respiratory system to remove more carbon dioxide than is produced. Respiratory alkalosis can be acute or chronic. Acute respiratory alkalosis is when the PaCO2 level is below the lower limit of normal and the serum pH is alkalemic. Chronic respiratory alkalosis is when the PaCO2 level is below the lower limit of normal, but the pH level is relatively normal or near normal. Respiratory alkalosis is the most common acid-base abnormality observed in patients who are critically ill. It is associated with numerous illnesses and is a common finding in patients on mechanical ventilation. Many cardiac and pulmonary disorders can occur with respiratory alkalosis. When respiratory alkalosis is present, the cause may be a minor or non–life-threatening disorder. However, more serious disease processes should also be considered in the differential diagnosis (Byrd, 2017). Hyperventilation is most likely the underlying cause of respiratory alkalosis. Hyperventilation is also known as over breathing (O’Connell, 2017).
Acid-Base balance is the state of equilibrium between proton donors and proton acceptors in the buffering system of the blood that is maintained at approximately pH 7.35 to 7.45 under normal conditions in arterial blood. It is important to regulate chemical balance or homeostasis of body fluids. Acidity or alkalinity has to be regulated. An acid is a substance that lets out hydrogen ions in solution. Strong acid like hydrochloric acid release all or nearly all their hydrogen ions and weak acids like carbonic acid release some hydrogen ions.
If the patient has an inadequate or no oral intake of food for 1 - 3 days, then nutritional support by the enteral route is required.
...ed that the liver was able to detoxify sulfate properly. The last inorganic constituent tested was calcium, which was done by adding equal amounts of urine and Sulkowitch’s reagent. A large amount of white precipitate was form due to the dietary consumption of the subject which can be that milk was consumed daily. Finally, the last tested was the abnormal constituents of urine. When testing for glucose the results were negative because the reagent was not reduced meaning that it did not turned greenish or red-brown color. The presence of glucose indicates diabetes mellitus which is a metabolic disorder that is caused by the usage of defective carbohydrate. Then when testing for albumin and globulin the results showed that a large amount of protein was present, which means that the subject had an abnormal leakiness or severe damage of the glomerular membrane or both.