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Dka Anion Gap Range

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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis

Metabolic Acidosis

Increases 0.3-0.7 mEq/l [0.3-0.7 mmol/L] per 0.1 decr pH Difference between measured plasma cation (ie, Na+) and anions (ie, chloride (Cl-), HCO3-) concentrations Lactic acidosis (mild LA may have normal AG) Also called hyperchloremic acidosis (decreased HCO3, increased Cl) Renal tubular acidosis: impairment in renal acidification Type III (term no longer used) Formerly used to define distal RTA with bicarbonate wasting in children Bicarbonaturia resolves with age and is not truly part of a pathologic process Type IV: common in obstructive nephropathy, DM, hyporenin/hypoaldosteronehyper K+, acidosis Intestinal loss of bicarbonate (diarrhea, pancreatic fistula) Carbonic anhydrase inhibitors (e.g. acetazolamide) Dilutional acidosis (due to rapid infusion of bicarbonate-free isotonic saline) Ingestion of exogenous acids (ammonium chloride, methionine, cystine, calcium chloride) Drugs: amiloride, triamterine, Bactrim, chemotherapy, pentamidines As diagnostic aid, is not absolute "Delta gap" = calculated anion gap:nl anion gap In anion gap acidosis, "delta gap" should equal "delta HCO3" If HCO3 higher than predictedsuperimposed metabolic alkalosis If HCO3 lower than predictedsuperimpos Continue reading >>

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Popular Questions

  1. TheCommuter

    You can post this question on this site's Nursing Student Assistance Forums and perhaps get an answer. One of our frequent users, Daytonite, loves to give detailed answers to these types of questions.
    http://allnurses.com/forums/f205/

  2. ICRN2008

    Here is the formula for anion gap:
    Agap = Na + K - Cl -CO2
    I would think that the doctor would be monitoring the glucose level (not the agap) to determine when to stop the insulin drip. Anyone else have an idea?

  3. P_RN

    One of our wonderful members Mark Hammerschmidt has a great FREE MICU site:
    http://www.icufaqs.org/
    Check section 4.2
    It's all acidosis/alkalosis

  4. -> Continue reading
read more
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Metabolic Acidosis Nursing Management And Interventions - Nurseslabs

Metabolic Acidosisis an acid-base imbalance resulting from excessive absorption or retention of acid or excessive excretion of bicarbonate produced by an underlying pathologic disorder. Symptoms result from the bodys attempts to correct the acidotic condition through compensatory mechanisms in the lungs , kidneys and cells. Metabolic acidosis is characterized by normal or high anion gap situations. If the primary problem is direct loss of bicarbonate, gain of chloride, or decreased ammonia production, the anion gap is within normal limits. If the primary problem is the accumulation of organic anions (such as ketones or lactic acid), the condition is known as high anion gap acidosis. Compensatory mechanisms to correct this imbalance include an increase in respirations to blow off excess CO2, an increase in ammonia formation, and acid excretion (H+) by the kidneys, with retention of bicarbonate and sodium . High anion gap acidosis occurs in diabetic ketoacidosis ; severe malnutrition or starvation, alcoholic lactic acidosis; renal failure; high-fat, low-carbohydrate diets/lipid administration; poisoning, e.g., salicylate intoxication (after initial stage); paraldehyde intoxication; Continue reading >>

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Popular Questions

  1. TheCommuter

    You can post this question on this site's Nursing Student Assistance Forums and perhaps get an answer. One of our frequent users, Daytonite, loves to give detailed answers to these types of questions.
    http://allnurses.com/forums/f205/

  2. ICRN2008

    Here is the formula for anion gap:
    Agap = Na + K - Cl -CO2
    I would think that the doctor would be monitoring the glucose level (not the agap) to determine when to stop the insulin drip. Anyone else have an idea?

  3. P_RN

    One of our wonderful members Mark Hammerschmidt has a great FREE MICU site:
    http://www.icufaqs.org/
    Check section 4.2
    It's all acidosis/alkalosis

  4. -> Continue reading
read more
Share on facebook

The text used in the video is only for tutorial purpose. The text was copied from the article "Glucose clamp technique: a method for quantifying insulin secretion and resistance" published in American Journal of Physiology - Gastrointestinal and Liver Physiology Published 1 September 1979 Vol. 237 no. 3. Here I am not using the text in real article. This was just copied for the sake of teaching how to insert references in an article. For list of BibLaTex styles go to "https://www.sharelatex.com/learn/Bibl..."

References

Arterial samples: pH 7.36-7.44, HCO3 21-27, PCO2 36-44 Venous: pH 0.03 units lower, HCO3 similar, PCO2 3-8 higher Capillary: similar to arterial (assuming no prolonged tourniquet use, ischemia, etc) 1. Look at the pH. What is the primary process occurring? low pH and high PCO2: respiratory acidosis high pH and low PCO2: respiratory alkalosis high pH and high HCO3: metabolic alkalosis if the pH is near normal but PCO2 and HCO3 are significantly abnormal, there is likely a mixed disorder 2. Assess the degree/chronicity of compensation present. Acute respiratory acidosis: HCO3 increases by 1 me/L and pH decreased by 0.08 for every 10 mmHg increase in PCO2 Chronic respiratory acidosis (3-5 days for renal compensation): HCO3 increases by 4me/Lfor and pH decreased by 0.03 for every 10 mmHg increase in PCO2 Metabolic acidosis: Expected PCO2= 1.5 X HCO3 + 8 +/-2 (Winter's Formula) or the decimal digits of pH should be similar to the PCO2 (ie pH 7.25 should have a PCO2 of 25 in a metabolic acidosis). If the patient's PCO2 is higher than expected, there is a concurrent respiratory acidosis. If the patient's PCO2 is lower than expected, there is a concurrent respiratory alkalosis. If it simi Continue reading >>

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Popular Questions

  1. TheCommuter

    You can post this question on this site's Nursing Student Assistance Forums and perhaps get an answer. One of our frequent users, Daytonite, loves to give detailed answers to these types of questions.
    http://allnurses.com/forums/f205/

  2. ICRN2008

    Here is the formula for anion gap:
    Agap = Na + K - Cl -CO2
    I would think that the doctor would be monitoring the glucose level (not the agap) to determine when to stop the insulin drip. Anyone else have an idea?

  3. P_RN

    One of our wonderful members Mark Hammerschmidt has a great FREE MICU site:
    http://www.icufaqs.org/
    Check section 4.2
    It's all acidosis/alkalosis

  4. -> Continue reading
read more

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