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Metabolic Acidosis Pathophysiology

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What is CLINICAL PATHWAY? What does CLINICAL PATHWAY mean? CLINICAL PATHWAY meaning - CLINICAL PATHWAY definition - CLINICAL PATHWAY explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... A clinical pathway, also known as care pathway, integrated care pathway, critical pathway, or care map, is one of the main tools used to manage the quality in healthcare concerning the standardisation of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes. Clinical pathways aim to promote organised and efficient patient care based on evidence-based medicine, and aim to optimise outcomes in settings such as acute care and home care. A single clinical pathway may refer to multiple clinical guidelines on several topics in a well specified context. A clinical pathway is a multidisciplinary management tool based on evidence-based practice for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimized and sequenced either by hour (ED), day (acute care) or visit (homecare). Outcomes are tied to specific interventions. The concept of clinical pathways may have different meanings to different stakeholders. Managed care organizations often view clinical pathways in a similar way as they view care plans, in which the care provided to a patient is definitive and deliberate. Clinical pathways can range in scope from simple medication utilization to a comprehensive treatment plan. Clinical pathways aim for greater standardization of treatment regimens and sequencing as well as improved outcomes, from both a quality of life and a clinical outcomes perspective. Clinical pathways (integrated care pathways) can be seen as an application of process management thinking to the improvement of patient healthcare. An aim is to re-center the focus on the patient's overall journey, rather than the contribution of each specialty or caring function independently. Instead, all are emphasised to be working together, in the same way as a cross-functional team. More than just a guideline or a protocol, a care pathway is typically recorded in a single all-encompassing bedside document that will stand as an indicator of the care a patient is likely to be provided in the course of the pathway going forward; and ultimately as a single unified legal record of the care the patient has received, and the progress of their condition, as the pathway has been undertaken. The pathway design tries to capture the foreseeable actions which will most commonly represent best practice for most patients most of the time, and include prompts for them at the appropriate time in the pathway document to ascertain whether they have been carried out, and whether results have been as expected. In this way results are recorded, and important questions and actions are not overlooked. However, pathways are typically not prescriptive; the patient's journey is an individual one, and an important part of the purpose of the pathway documents is to capture information on "variances", where due to circumstances or clinical judgment different actions have been taken, or different results unfolded. The combined variances for a sufficiently large population of patients are then analysed to identify important or systematic features, which can be used to improve the next iteration of the pathway.

Metabolic Acidosis | Pathway Medicine

Metabolic Acidosis is a pathophysiological category of acidosis that refers to any cause of decreased ECF pH not due to a ventilatory defect (i.e. Respiratory Acidosis). Although the primary metabolic disturbance can cause a significant decrease in blood pH, respiratory compensatory mechanisms can largely correct the pH over several hours. The fundamental primary disturbance in a metabolic acidosis is a decrease in the levels of ECF bicarbonate concentration ([HCO3-]). Decreased bicarbonate results in an misalignment of the Henderson-Hasselbalch Equation for the bicarbonate buffer which largely determines the pH of the extracellular fluid. Mathematically, the reduced ECF pH results from an increase in the ratio between the partial pressure of arterial carbon dioxide (PaCO2) relative to the ECF concentration of bicarbonate ([HCO3-]). More colloquially, metabolic acidoses are caused by a pathologic consumption of the weak base form of the bicarbonate buffer, that is bicarbonate (HCO3-), resulting in a decrease in ECF pH. Metabolic Acidoses can be compensated by the actions of the lungs which serve to realign the bicarbonate buffer Henderson-Hasselbalch Equation over a period of hour Continue reading >>

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  1. boobear

    Hi everyone, I've done keto/low carb on/off last few years. Got really keto serious three weeks ago. On the whole last week my husband pretty much wanted to puke every time I spoke near him as he said my breath was soooo bad. I drink tons of water, chew gum etc. It was making me so self conscious that I went off the next day. It's been two days off and Breath is better but I really hate the way I feel eating carbs. Is there any tips for the keto breath, will it pass, and if so after how long??? It is literally the only thing that stops me from going back! Thanks in advance!

  2. Jessica

    They say that burning fat can cause bad breath due to chemicals released in the process. It's metabolic and not hygiene related. It doesn't usually last forever! Don't let it discourage you! Keep drinking lots of water

  3. boobear

    I'm trying really hard not too! I'm going to get back on tomorrow and keep ketoing but I hate being paranoid about my breath :(.

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

Metabolic Acidosis In Emergency Medicine

Background Metabolic acidosis is a clinical disturbance characterized by an increase in plasma acidity. Metabolic acidosis should be considered a sign of an underlying disease process. Identification of this underlying condition is essential to initiate appropriate therapy. This article discusses the differential diagnosis of metabolic acidosis and presents a scheme for identifying the underlying cause of acidosis by using laboratory tests that are available in the emergency department. Clinical strategies for treating metabolic acidosis are also reviewed. Continue reading >>

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  1. nboylie

    I have searched rexall and shoppers drug mart and I can't seem to find them?

  2. quality_time

    I get mine at shoppers. I ask for them from the pharmacist as they keep them behind the counter. I've also gotten them from the pharmacy at the grocery store - same deal behind the counter. If they don't have them behind the counter it's on order. Typically with the diabetic stuff.

  3. rolodex9

    yep, Shoppers has them behind the pharmacists counter. In regards to how expensive they are, I combat that by cutting mine in half. They're still readable and instead of 50 you get 100 strips

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Acid-base Physiology

8.4.1 Is this the same as normal anion gap acidosis? In hyperchloraemic acidosis, the anion-gap is normal (in most cases). The anion that replaces the titrated bicarbonate is chloride and because this is accounted for in the anion gap formula, the anion gap is normal. There are TWO problems in the definition of this type of metabolic acidosis which can cause confusion. Consider the following: What is the difference between a "hyperchloraemic acidosis" and a "normal anion gap acidosis"? These terms are used here as though they were synonymous. This is mostly true, but if hyponatraemia is present the plasma [Cl-] may be normal despite the presence of a normal anion gap acidosis. This could be considered a 'relative hyperchloraemia'. However, you should be aware that in some cases of normal anion-gap acidosis, there will not be a hyperchloraemia if there is a significant hyponatraemia. In a disorder that typically causes a high anion gap disorder there may sometimes be a normal anion gap! The anion gap may still be within the reference range in lactic acidosis. Now this can be misleading to you when you are trying to diagnose the disorder. Once you note the presence of an anion gap w Continue reading >>

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  1. Denae

    I am supposed to use the "MultiStix" twice a week to check several things-
    -Ketones
    -blood in urine
    -specific gravity
    Her ketones have been whacky today, I am not sure if it was the cream I was using (lowes store brand?) or what, but I went back to the food lion brand and she is back to 4+ tonight.
    We are still having an issue getting her to drink enough, even with bribes and forcing a syringe of water/flavored water into her mouth. Her specific gravity is 1.030- which means she isn't getting enough fluids. No shock there...
    The Immediate problem is the blood- is should be yellow meaning "negative" no blood- when I just checked it a few minutes ago it had little green dots on it which says "trace" for blood...
    Is it something that can wait until monday morning? Or should I call? I am trying to check it again to be certain, but this was pretty obvious it wasn't an error.
    I don't know what I am supposed to do, if anything.
    Ri is high risk for kidney stones, thats not what that means is it?
    She had to have her Zonegran reduced since she already had crystals in her urine on the pre admission labs.
    She is on polycitra-K and neutra phos already....
    ???????

  2. RathyKay

    (((Hugs))) I haven't a clue. I associate blood in the urine with bladder infections. I'm assuming since they have you test for it that it also means something else. And I don't know what. (((Hugs))) Hope you called in and got some answers.

  3. grace

    sweetie, you need someone with knowledge and I don't have it for this. sorry, but i'm agitated right along with you. hate this right along with you... but hoping there's no negative significance to it and that this is all going to continue to get better and help Riley.
    Hugs,

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