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Dehydration Metabolic Acidosis Or Alkalosis

Alkalosis & Dehydration: Causes & Diagnoses | Symptoma.com

Alkalosis & Dehydration: Causes & Diagnoses | Symptoma.com

Metabolic derangements may cause renal failure via nephrocalcinosis and inability to compensate for alkalosis and dehydration. [medical-dictionary.thefreedictionary.com] The defining features of the syndrome are the triad: metabolic alkalosis, hypercalcemia and renal failure. [acutecaretesting.org] Any form of dehydrating debility or chronic dehydration can predispose a person to calcium-alkali syndrome. [allnutriments.blogspot.com] Severe Dehydration Chronic diarrhea associated with long-term laxative abuse is almost always associated with dehydration. [gethelpforeatingdisorders.com] If patient is hemodynamically stable and without significant abnormalities in serum sodium, give normal saline boluses or oral replacement to correct metabolic alkalosis ( [5minuteconsult.com] No evidence of metabolic alkalosis. [anaesthesiamcq.com] PHASE 3 Phase 3 includes dehydration, hypokalemia, and progressive metabolic acidosis. [nursingcrib.com] Stolbach AI, Hoffm... 276.2 Acidosis 276.3 Alkalosis 965.1 Poisoning by salicylates E87.2 Acidosis E87.3 Alkalosis T39.011A Poisoning by aspirin , accidental (unintentional [5minuteconsult.com] Vomiting contributes significantly to electrolyte imbalance and dehydration. [curriculum.toxicology.wikispaces.net] The child was somewhat sleepy and looked grossly dehydrated, probably because of frequent vomiting. [medindia.net] Projectile vomiting (non bile-stained fluid) Weight loss, child becomes emaciated and dehydrated. Hypertrophied pylorus is palpated in the epigastrium (olive). [medicinembbs.blogspot.com] PATHOPHYSIOLOGY Vomiting loss of H and Cl Hypochloremic hypokalemic metabolic alkalosis Protracted vomiting ECF volume deficit urinary excretion of K and H to preserve [slideshare.net] Be sure to watch for signs of dehydration if vomiting Continue reading >>

Nclex: Fluid And Electrolyte And Acid/base Balance

Nclex: Fluid And Electrolyte And Acid/base Balance

NCLEX: Fluid and Electrolyte and Acid/Base Balance Focus topic:Fluid and Electrolyte and Acid/Base Balance Cells maintain a balance, or homeostasis, by transference of fluid and electrolytes in and out of the cell. This fluid constantly bathes the cell. Although fluid and electrolyte balance and acid/base balance are separate entities, they directly relate to one another. For example, dehydration results in a decrease in the pH or metabolic acidosis, whereas overhydration results in an increase in the pH or metabolic alkalosis. To understand how this happens, lets review the basics of fluid movement across the cell membrane. Water and small particles constantly move in and out of the semipermeable membrane in the cell through active transport and osmosis. This process transports nutrients, hormones, proteins, and other molecules into the cell. It also aids in the movement of waste products out of the cell for excretion from the body. Along with other functions, fluid also assists with body temperature regulation. When the client has an infection resulting in an elevated temperature, he tends to perspire. This loss of body fluid can lead to dehydration. Dehydration occurs when there is more fluid output than fluid intake. Other body fluids exist in the form of pericardial fluid, pleural fluid, and spinal fluid. These fluids are compartmentalized into two types: Intracellular fluid (fluid that is within the cell): Two-thirds of the bodys fluid is intracellular. Extracellular fluid (fluid that is outside the cell): One-third of the bodys fluid is extracellular. These fluids are divided between the intravascular and interstitial spaces. Fluid and Electrolyte and Acid/Base Balance: Total Body Water Calculation Focus topic:Fluid and Electrolyte and Acid/Base Balance The dist Continue reading >>

Metabolic Acidosis And Alkalosis

Metabolic Acidosis And Alkalosis

Page Index Metabolic Acidosis. Metabolic Alkalosis Emergency Therapy Treating Metabolic Acidosis Calculating the Dose Use Half the Calculated Dose Reasons to Limit the Bicarbonate Dose: Injected into Plasma Volume Fizzes with Acid Causes Respiratory Acidosis Raises Intracellular PCO2 Subsequent Residual Changes Metabolic Acidosis. The following is a brief summary. For additional information visit: E-Medicine (Christie Thomas) or Wikepedia Etiology: There are many causes of primary metabolic acidosis and they are commonly classified by the anion gap: Metabolic Acidosis with a Normal Anion Gap: Longstanding diarrhea (bicarbonate loss) Uretero-sigmoidostomy Pancreatic fistula Renal Tubular Acidosis Intoxication, e.g., ammonium chloride, acetazolamide, bile acid sequestrants Renal failure Metabolic Acidosis with an Elevated Anion Gap: lactic acidosis ketoacidosis chronic renal failure (accumulation of sulfates, phosphates, uric acid) intoxication, e.g., salicylates, ethanol, methanol, formaldehyde, ethylene glycol, paraldehyde, INH, toluene, sulfates, metformin. rhabdomyolysis For further details visit: E-Medicine (Christie Thomas). Treating Severe Metabolic Acidosis. The ideal treatment for metabolic acidosis is correction of the underlying cause. When urgency dictates more rapid correction, treatment is based on clinical considerations, supported by laboratory evidence. The best measure of the level of metabolic acidosis is the Standard Base Excess (SBE) because it is independent of PCO2. If it is decided to administer bicarbonate, the SBE and the size of the treatable space are used to calculate the dose required: Metabolic Alkalosis Etiology: Primary Metabolic alkalosis may occur from various causes including: Loss of acid via the urine, stools, or vomiting Transfer of Continue reading >>

Metabolic Alkalosis - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

Metabolic Alkalosis - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

(Video) Overview of Buffering and the Henderson-Hasselbalch Equation By James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincents Ascension Health, Birmingham Metabolic alkalosis is primary increase in bicarbonate (HCO3) with or without compensatory increase in carbon dioxide partial pressure (Pco2); pH may be high or nearly normal. Common causes include prolonged vomiting, hypovolemia, diuretic use, and hypokalemia. Renal impairment of HCO3 excretion must be present to sustain alkalosis. Symptoms and signs in severe cases include headache, lethargy, and tetany. Diagnosis is clinical and with arterial blood gas and serum electrolyte measurement. The underlying condition is treated; oral or IV acetazolamide or hydrochloric acid is sometimes indicated. Metabolic alkalosis is bicarbonate (HCO3) accumulation due to Intracellular shift of hydrogen ion (H+as occurs in hypokalemia ) Regardless of initial cause, persistence of metabolic alkalosis indicates that the kidneys have increased their HCO3 reabsorption, because HCO3 is normally freely filtered by the kidneys and hence excreted. Volume depletion and hypokalemia are the most common stimuli for increased HCO3 reabsorption, but any condition that elevates aldosterone or mineralocorticoids (which enhance sodium [Na] reabsorption and potassium [K] and hydrogen ion [H+] excretion) can elevate HCO3. Thus, hypokalemia is both a cause and a frequent consequence of metabolic alkalosis. The most common causes of metabolic alkalosis are Volume depletion (particularly when involving loss of gastric acid and chloride [Cl] due to recurrent vomiting or nasogastric suction) Among other causes (see Table: Causes of Metabolic Alkalosis ) are disorders that cause Continue reading >>

The Treatment Of Dehydration, Acidosis And Alkalosis

The Treatment Of Dehydration, Acidosis And Alkalosis

THE TREATMENT OF DEHYDRATION, ACIDOSIS AND ALKALOSIS Under various circumstances a syndrome called dehydration develops. The patient shows diminished turgor of the skin, sunken eyes, poor circulation, oliguria and concentration of the blood with respect to red cells and serum proteins. While an inadequate intake of water will produce some of these symptoms, the fully developed picture occurs almost exclusively when, as a result of vomiting, diarrhea, sweating or abnormal diuresis, the body has lost extracellular electrolyte (salts) as well as water. Furthermore, this fully developed picture of dehydration can be produced when extracellular electrolyte is no longer available to the body as a whole because it has been fixed in the inflammatory exudate of a burn. In dehydration the evidences of loss of fluid volume are confined chiefly to extracellular fluids. The central feature is the deficiency of extracellular electrolyte, since dehydration can develop either with or without loss of water from the body as a Continue reading >>

Acidosis

Acidosis

The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory or metabolic acidosis. Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused when the body is unable to remove enough carbon dioxide through breathing. Other names for respiratory acidosis are hypercapnic acidosis and carbon dioxide acidosis. Causes of respiratory acidosis include: Chest deformities, such as kyphosis Chest injuries Chest muscle weakness Chronic lung disease Overuse of sedative drugs Metabolic acidosis develops when too much acid is produced in the body. It can also occur when the kidneys cannot remove enough acid from the body. There are several types of metabolic acidosis: Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes. Hyperchloremic acidosis is caused by the loss of too much sodium bicarbonate from the body, which can happen with severe diarrhea. Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol Lactic acidosis is a buildup of lactic acid. Lactic acid is mainly produced in muscle cells and red blood cells. It forms when the body breaks down carbohydrates to use for energy when oxygen levels are low. This can be caused by: Cancer Drinking too much alcohol Exercising vigorously for a very long time Liver failure Low blood sugar (hypoglycemia) Medications, such as salicylates MELAS (a very rare genetic mitochondrial disorder that affects energy production) Prolonged lack of oxygen from shock, heart failure, or seve Continue reading >>

What Is Metabolic Acidosis?

What Is Metabolic Acidosis?

Metabolic acidosis happens when the chemical balance of acids and bases in your blood gets thrown off. Your body: Is making too much acid Isn't getting rid of enough acid Doesn't have enough base to offset a normal amount of acid When any of these happen, chemical reactions and processes in your body don't work right. Although severe episodes can be life-threatening, sometimes metabolic acidosis is a mild condition. You can treat it, but how depends on what's causing it. Causes of Metabolic Acidosis Different things can set up an acid-base imbalance in your blood. Ketoacidosis. When you have diabetes and don't get enough insulin and get dehydrated, your body burns fat instead of carbs as fuel, and that makes ketones. Lots of ketones in your blood turn it acidic. People who drink a lot of alcohol for a long time and don't eat enough also build up ketones. It can happen when you aren't eating at all, too. Lactic acidosis. The cells in your body make lactic acid when they don't have a lot of oxygen to use. This acid can build up, too. It might happen when you're exercising intensely. Big drops in blood pressure, heart failure, cardiac arrest, and an overwhelming infection can also cause it. Renal tubular acidosis. Healthy kidneys take acids out of your blood and get rid of them in your pee. Kidney diseases as well as some immune system and genetic disorders can damage kidneys so they leave too much acid in your blood. Hyperchloremic acidosis. Severe diarrhea, laxative abuse, and kidney problems can cause lower levels of bicarbonate, the base that helps neutralize acids in blood. Respiratory acidosis also results in blood that's too acidic. But it starts in a different way, when your body has too much carbon dioxide because of a problem with your lungs. Continue reading >>

Alkalosis, Dehydration, Tetany, Acidosis: Causes & Diagnoses | Symptoma.com

Alkalosis, Dehydration, Tetany, Acidosis: Causes & Diagnoses | Symptoma.com

Symptoms of rotavirus include fever, vomiting, and non-bloody diarrhea that can lead to mild to severe dehydration. How is it spread? [immunize.ca] Synonyms [ edit ] ( disease caused by Clostridium tetani ) : lockjaw Derived terms [ edit ] tetanal tetanic tetany tetanize tetanization Translations [ edit ] Anagrams [ edit [en.wiktionary.org] Tetanus causes Tetanus is caused by infection with a bacterium called Clostridium tetani (C. tetani) . [healthdirect.gov.au] Tetanus is an infection of the nervous system with a type of bacteria that is potentially deadly, called Clostridium tetani (C tetani) . [nlm.nih.gov] Electrolyte disturbances include hypokalaeynia and gypocalcaemia, which clinically are manifested by arrythmias, tetany and seizures. [jpma.org.pk] PHASE 3 Phase 3 includes dehydration, hypokalemia, and progressive metabolic acidosis. [nursingcrib.com] Acid-Base Disorders in Salicylate Toxicity Adults : Metabolic acidosis AND Respiratory alkalosis Children : Metabolic acidosis If fasting starvation ketosis may develop Regarding [anaesthesiamcq.com] Stolbach AI, Hoffm... 276.2 Acidosis 276.3 Alkalosis 965.1 Poisoning by salicylates E87.2 Acidosis E87.3 Alkalosis T39.011A Poisoning by aspirin , accidental (unintentional [5minuteconsult.com] Physical ( for nasogastric resuscitation ) Bradycardia ( 50 bpm) Postural hypotension (fall in systolic BP lying to standing 20 mmHg) Dehydration Hypothermia (temp. [rch.org.au] These changes are a response to a decrease in the basal metabolic rate. [emedicine.medscape.com] Low calcium levels can lead to muscle spasms (tetany). Anorexia can also cause low sugar levels. [patient.info] Limited fluid intake can cause dehydration and highly concentrated urine. [stanfordchildrens.org] Be sure to watch for signs of dehydration if vom Continue reading >>

Metabolic Alkalosis

Metabolic Alkalosis

Metabolic alkalosis is a metabolic condition in which the pH of tissue is elevated beyond the normal range (7.35–7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations. Terminology[edit] Alkalosis refers to a process by which the pH is increased. Alkalemia refers to a pH which is higher than normal, specifically in the blood. Causes[edit] The causes of metabolic alkalosis can be divided into two categories, depending upon urine chloride levels.[1] Chloride-responsive (Urine chloride < 10 mEq/L)[edit] Loss of hydrogen ions - Most often occurs via two mechanisms, either vomiting or via the kidney. Vomiting results in the loss of hydrochloric acid (hydrogen and chloride ions) with the stomach contents. In the hospital setting this can commonly occur from nasogastric suction tubes. Severe vomiting also causes loss of potassium (hypokalaemia) and sodium (hyponatremia). The kidneys compensate for these losses by retaining sodium in the collecting ducts at the expense of hydrogen ions (sparing sodium/potassium pumps to prevent further loss of potassium), leading to metabolic alkalosis.[2] Congenital chloride diarrhea - rare for being a diarrhea that causes alkalosis instead of acidosis.[3] Contraction alkalosis - This results from a loss of water in the extracellular space, such as from dehydration. Decreased extracellular volume triggers the renin-angiotensin-aldosterone system, and aldosterone subsequently stimulates reabsorption of sodium (and thus water) within the nephron of the kidney. However, a second action of aldosterone is to stimulate renal excretion of hydrogen ions (while retaining bicarbonate), and it is this loss of hydrogen ions that raises Continue reading >>

Causes Of Metabolic Alkalosis

Causes Of Metabolic Alkalosis

INTRODUCTION Metabolic alkalosis, a disorder that elevates the serum bicarbonate, can result from several mechanisms: intracellular shift of hydrogen ions; gastrointestinal loss of hydrogen ions; excessive renal hydrogen ion loss; administration and retention of bicarbonate ions; or volume contraction around a constant amount of extracellular bicarbonate (contraction alkalosis) (table 1) [1-4]. Hydrogen ions are derived from the dissociation of water into hydrogen and hydroxyl ions; therefore, when hydrogen ions are removed from the extracellular fluid, the remaining hydroxyl ion combines with carbon dioxide to form bicarbonate. Gastrointestinal and renal hydrogen loss is usually accompanied by the loss of chloride and potassium, resulting in hypochloremia and hypokalemia. Patients with preserved renal function will most often rapidly excrete excess bicarbonate in the urine. Thus, metabolic alkalosis can only persist if the ability to excrete excess bicarbonate in the urine is impaired due to one of the following causes: hypovolemia; reduced effective arterial blood volume (due, for example, to heart failure or cirrhosis); chloride depletion; hypokalemia; reduced glomerular filtration rate; hyperaldosteronism; or combinations of these factors [3,5,6]. The causes of metabolic alkalosis will be reviewed here. The pathogenesis, evaluation, and treatment of this disorder are discussed separately. (See "Pathogenesis of metabolic alkalosis" and "Clinical manifestations and evaluation of metabolic alkalosis" and "Treatment of metabolic alkalosis".) INTRACELLULAR SHIFT OF HYDROGEN Metabolic alkalosis can be generated by a shift of hydrogen ions into the cells. This most often occurs in patients with potassium deficits and hypokalemia. This may be an important pathophysiologic m Continue reading >>

Pediatric Dehydration

Pediatric Dehydration

Author: Alex Koyfman, MD; Chief Editor: Muhammad Waseem, MBBS, MS, FAAP, FACEP, FAHA more... Dehydration is a common complication of illness observed in pediatric patients presenting to the emergency department (ED). Early recognition and early intervention are important to reduce risk of progression to hypovolemic shock and end-organ failure. In most cases, volume depletion in children is caused by fluid losses from vomiting or diarrhea. On physical examination, combinations of findings can be used to determine the degree of dehydration. Laboratory studies are of limited utility in cases of mild dehydration, but they may be considered under certain conditions and are recommended in patients with more severe dehydration. Mild or moderate volume depletion should be treated with oral rehydration when possible. Intravenous fluid therapy is necessary when oral therapy fails or volume depletion is severe. For patient education information, see the Children's Health Center , as well as Dehydration in Children . The terms dehydration and volume depletion are commonly used interchangeably but they refer to different physiologic conditions resulting from different types of fluid loss. [ 1 ] Volume depletion denotes reduction of effective circulating volume in the intravascular space, whereas dehydration denotes loss of free water in greater proportion than the loss of sodium. The distinction is important because volume depletion and dehydration can exist independently or concurrently and the treatment for each is different. However, much of clinical literature does not differentiate between the 2 conditions; this article will therefore follow this convention and use the terms dehydration, hypovolemia, and volume depletion interchangeably to refer to intravascular fluid deficits Continue reading >>

Contraction Alkalosis

Contraction Alkalosis

Contraction alkalosis refers to the increase in blood pH that occurs as a result of fluid losses ( volume contraction ). The change in pH is especially pronounced with acidic fluid losses caused by problems like vomiting . There are several possible explanations for the process of alkalosis observed after volume contraction. One popular theory is that alkalosis is simply the loss of solvent volume without a proportional loss in bicarbonate concentration or increase in carbon dioxide concentration. [1] [2] This explanation may be especially appropriate for the very short term after volume loss. Another suggests that the alkalosis is due to renal compensatory mechanisms used to correct volume loss. Extracellular fluid (ECF) volume contraction is associated with decreased blood volume and decreased renal perfusion pressure. Three compensation mechanisms engage as a result: production of angiotensin II is increased, and Increases in angiotensin II cause increased Na+-H+ exchange in the proximal tubule and increased HCO3 (bicarbonate) reabsorption in the proximal tubule due to increased luminal H+. Increased aldosterone secretion stimulates the H-ATPase of alpha-intercalated cells of the collecting duct, which causes 1) increased distal tubule H+ secretion, worsening the metabolic alkalosis, and 2) increased generation of "new" bicarbonate within these same cells, which will be reabsorbed. Additionally, increased aldosterone secretion causes increased collecting duct K+ secretion, in turn causing the hypokalemia seen with contraction alkalosis. Finally, it has been suggested that the term "contraction alkalosis" is actually a misnomer, and that the alkalosis observed during volume contraction is actually attributable entirely to chloride depletion, which leads to a failure Continue reading >>

Metabolic Acidosis

Metabolic Acidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find one of our health articles more useful. See also separate Lactic Acidosis and Arterial Blood Gases - Indications and Interpretations articles. Description Metabolic acidosis is defined as an arterial blood pH <7.35 with plasma bicarbonate <22 mmol/L. Respiratory compensation occurs normally immediately, unless there is respiratory pathology. Pure metabolic acidosis is a term used to describe when there is not another primary acid-base derangement - ie there is not a mixed acid-base disorder. Compensation may be partial (very early in time course, limited by other acid-base derangements, or the acidosis exceeds the maximum compensation possible) or full. The Winter formula can be helpful here - the formula allows calculation of the expected compensating pCO2: If the measured pCO2 is >expected pCO2 then additional respiratory acidosis may also be present. It is important to remember that metabolic acidosis is not a diagnosis; rather, it is a metabolic derangement that indicates underlying disease(s) as a cause. Determination of the underlying cause is the key to correcting the acidosis and administering appropriate therapy[1]. Epidemiology It is relatively common, particularly among acutely unwell/critical care patients. There are no reliable figures for its overall incidence or prevalence in the population at large. Causes of metabolic acidosis There are many causes. They can be classified according to their pathophysiological origin, as below. The table is not exhaustive but lists those that are most common or clinically important to detect. Increased acid Continue reading >>

Dehydration And Acidosis

Dehydration And Acidosis

M. Gideon Hoyle is a writer living outside of Houston. Previously, he produced brochures and a wide variety of other materials for a nonprofit educational foundation. He now specializes in topics related to health, exercise and nutrition, publishing for various websites. A woman takes a rest from running in the park with a bottle of water.Photo Credit: m-imagephotography/iStock/Getty Images Fluid depletion, also called dehydration, is a condition characterized by decreases in fluid consumption, increases in fluid loss or a combination of these two factors. If left untreated, dehydration can have serious medical consequences, including the development of metabolic acidosis, a condition marked by an excessive production of body acids or impairments in normal acid removal. In most cases, dehydration is caused by the presence of diarrhea, according to the Merck Manuals Online Medical Library. The University of Maryland Medical Center (UMMC) lists additional potential causes that include sun overexposure and use of fluid-depleting medications such as diuretics. Typically, your loss of body fluid will be accompanied by a loss of body salts, or electrolytes, such as potassium, sodium and phosphorus. Infants, young children and the elderly are particularly at risk for the development of dehydration. The UMMC lists potential symptoms of dehydration as fatigue, thirst, dry skin, decreases in urine output or frequency, confusion, dry mouth, dry mucous membranes, lightheadedness, dizziness, and increases in breathing rate and heart rate. If your infant develops dehydration, he may experience additional symptoms that include lack of tears when crying, high fever, dry tongue and mouth, irritability, listlessness, abnormally slack skin, lack of a wet diaper for three hours or longer Continue reading >>

Alkalosis

Alkalosis

Your blood is made up of acids and bases. The amount of acids and bases in your blood can be measured on a pH scale. It’s important to maintain the correct balance between acids and bases. Even a slight change can cause health problems. Normally, your blood should have a slightly higher amount of bases than acids. Alkalosis occurs when your body has too many bases. It can occur due to decreased blood levels of carbon dioxide, which is an acid. It can also occur due to increased blood levels of bicarbonate, which is a base. This condition may also be related to other underlying health issues such as low potassium, or hypokalemia. The earlier it’s detected and treated, the better the outcome is. Acid-base balance » There are five main types of alkalosis. Respiratory alkalosis Respiratory alkalosis occurs when there isn’t enough carbon dioxide in your bloodstream. It’s often caused by: hyperventilation, which commonly occurs with anxiety high fever lack of oxygen salicylate poisoning being in high altitudes Metabolic alkalosis Metabolic alkalosis develops when your body loses too much acid or gains too much base. This can be attributed to: excess vomiting, which causes electrolyte loss overuse of diuretics a large loss of potassium or sodium in a short amount of time antacids accidental ingestion of bicarbonate, which can be found in baking soda laxatives alcohol abuse Hypochloremic alkalosis Hypochloremic alkalosis occurs when there’s a significant decline of chloride in your body. This can be due to prolonged vomiting or sweating. Chloride is an important chemical needed to maintain balance in bodily fluids, and it’s an essential part of your body’s digestive fluids. Hypokalemic alkalosis Hypokalemic alkalosis occurs when your body lacks the normal amount Continue reading >>

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