The nurse is caring for a patient with metabolic alkalosis who was transferred without lab data or the H&P. Which of the following is a potential cause of metabolic alkalosis?


• Hyperaldosteronism increases renal loss of hydrogen ions and increases sodium-hydrogen exchange in the kidney. Sodium retention causes excess fluid volume and the hydrogen ion loss leads to metabolic alkalosis.

Respiratory Acidosis:
• Respiratory system is the cause
• Increase in PCO2, decrease in pH
• Compensation - Kidneys reabsorb Bicarb (HCO3)

Metabolic Acidosis:
• Caused by loss of bicarb or build up of acids - lactic acidosis, diarrhea, renal failure, ketones, ammonium intoxication; not caused by respiration.
• HCO3 decreases, pH decreases
• Compensation - hyperventilation to eliminate CO2

Respiratory Alkalosis:
• Caused by excessive ventilation
• Decrease in PCO2, increase in pH
• Compensation - Kidneys excrete HCO3

Metabolic Alkalosis:
• Acid (H+) loss from emesis, diuretics.Or retention of HCO3 from medications, hyperaldosteronism
• Increase in HCO3, Increase in pH
• Compensation - Respiratory centers are not stimulated, this leads to hypoventilation and CO2 retention

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