diabetestalk.net

Nursing Interventions For Metabolic Acidosis

Perfecting Your Acid-base Balancing Act

Perfecting Your Acid-base Balancing Act

When it comes to acids and bases, the difference between life and death is balance. The body’s acid-base balance depends on some delicately balanced chemical reactions. The hydrogen ion (H+) affects pH, and pH regulation influences the speed of cellular reactions, cell function, cell permeability, and the very integrity of cell structure. When an imbalance develops, you can detect it quickly by knowing how to assess your patient and interpret arterial blood gas (ABG) values. And you can restore the balance by targeting your interventions to the specific acid-base disorder you find. Basics of acid-base balance Before assessing a patient’s acid-base balance, you need to understand how the H+ affects acids, bases, and pH. An acid is a substance that can donate H+ to a base. Examples include hydrochloric acid, nitric acid, ammonium ion, lactic acid, acetic acid, and carbonic acid (H2CO3). A base is a substance that can accept or bind H+. Examples include ammonia, lactate, acetate, and bicarbonate (HCO3-). pH reflects the overall H+ concentration in body fluids. The higher the number of H+ in the blood, the lower the pH; and the lower the number of H+, the higher the pH. A solution containing more base than acid has fewer H+ and a higher pH. A solution containing more acid than base has more H+ and a lower pH. The pH of water (H2O), 7.4, is considered neutral. The pH of blood is slightly alkaline and has a normal range of 7.35 to 7.45. For normal enzyme and cell function and normal metabolism, the blood’s pH must remain in this narrow range. If the blood is acidic, the force of cardiac contractions diminishes. If the blood is alkaline, neuromuscular function becomes impaired. A blood pH below 6.8 or above 7.8 is usually fatal. pH also reflects the balance between the p Continue reading >>

Metabolic Acidosis Nursing Management And Interventions - Nurseslabs

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; and drug therapy, e.g., acetazolamide (Diamox), NH4Cl. Normal anion gap acidosis is associated with loss of bicarbonate form the body, as may occur in renal tubular acidosis, hyperalimentation, vomiting/ diarrhea , small-bowel/pancreatic fistulas, and ileostomy and use of IV sodium chloride in presence of preexisting kidney dysfunction, acidifying drugs (e.g., ammonium chloride). This condition does not occur in isolation but rather is a complication of a broader problem that may require inpatient care in a medical-surgical or subacute unit. Use of carbonic anhydrase inhibitors or anion-exchan Continue reading >>

Nurse Nightingale: Metabolic Acidosis Study Guide

Nurse Nightingale: Metabolic Acidosis Study Guide

Email This BlogThis! Share to Twitter Share to Facebook Share to Pinterest Metabolic Acidosis is an acid-base imbalance in which the pH and the bicarbonate are both low. Being able to interpret and understand acid-base imbalances will not only show up on NCLEX but will also show up frequently in the hospital setting. This is a post over the signs and symptoms, causes, and treatments of Metabolic Acidosis. You might like to go back and review this post on ABGs: The Ultimate Beginners Guide . Metabolic Acidosis happens by either gaining hydrogen ions or losing bicarb. The pH is below 7.35 and the bicarb is below 22 mEq/L. Here's a table for a quick review: ROME: Respiratory Opposite. Metabolic Equal. Remember Metabolic Acidosis is from the ass (diarrhea). Just think, it puts the ass in acidosis. Hey, whatever helps me remember things, right? Metabolic Alkalosis is from the mouth (vomiting) **Excessive administration of isotonic saline or ammonium chloride** Respirations will increase to compensate. The patient begins to hyperventilate because the body is trying to decrease the CO2. Like everything else I ever post about, treatment depends on the cause. If the patient has renal failure, we can treat this with dialysis. If the patient is in Diabetic Ketoacidosis we treat with fluid replacement and insulin. Some providers might order sodium bicarb. Which means as the nurse you're observing for hypernatremia. (Which I've already posted about. YAY! Super Fantastic Handy Dandy Post on Hypernatremia ) Bicarb will be ordered when the cause of the metabolic acidosis is diarrhea. It could possibly be used in treating toxin poisonings too. There you have it. Metabolic Acidosis in a nut shell!! Here are the other posts in this series on acid-base imbalances: I didn't go into too man Continue reading >>

Metabolic Acidosis Nclex Review Notes

Metabolic Acidosis Nclex Review Notes

Are you studying metabolic acidosis and need to know a mnemonic on how to remember the causes? This article will give you a clever mnemonic and simplify the signs and symptoms and nursing interventions on how to remember metabolic acidosis for nursing lecture exams and NCLEX. In addition, you will learn how to differentiate metabolic acidosis from metabolic alkalosis. Don’t forget to take the metabolic acidosis and metabolic alkalosis quiz. This article will cover: Metabolic acidosis simplified Lab values expected with metabolic acidosis Causes of metabolic acidosis Signs and symptoms of metabolic acidosis Nursing interventions for metabolic acidosis Lecture on Metabolic Acidosis Metabolic Acidosis Metabolic Acidosis in Simple Terms: a metabolic problem due to the buildup of acid in the body fluids which affects the bicarbonate (HCO3 levels) either from: increased acid production (ex: DKA where ketones (acids) increase in the body which decreases bicarbonate) decreased acid excretion (ex: renal failure where there is high amount of waste left in the body which causes the acids to increase and bicarb can’t control imbalance) loss of too much bicarb (diarrhea) When this acidic phenomena is taking place in the body other systems will try to compensate to increase the bicarb back to normal. One system that tries to compensate is the respiratory system. In order to compensate, the respiratory system will cause the body to hyperventilate by increasing breathing through Kussmaul’s respirations. Kussmaul respirations are deep, rapid breathes. The body hopes this will help expel CO2 (an acid) which will “hopefully” increase the pH back to normal. Lab values expected in Metabolic Acidosis: HCO3: decreased <22 Blood pH: decreased <7.35 CO2: <35 or normal (may be normal b Continue reading >>

Anion Gap Acidosis | Allnurses

Anion Gap Acidosis | Allnurses

Can someone please explain the difference btwn non-anion and anion met acidosis, why it's important to know the difference and how do we treat/manage this? I just started in ICU and I have been hearing this a lot here. Have you researched this at all on the internet or in your textbooks? If you're a nurse, then you really should know how to research anything you're confused about. Rather than ask someone to take the time to teach you the basics, why not read up on the basics and then come with specific questions? Moved to our Critical Care forum for more replies. It depends on how messed up your electrolytes and bicarb are. There's a formula out there. A wide gap is bad. By correcting the acidoses and dehydration and fixing electrolyte issues you close the gap and balance the equation. Anion gap is a further step to figure out why a person has for instance, in this case, metabolic acidosis. I like to pretend it's a mystery obtain objective and subjective information. Patient is a 65 year old male admitted with moderate dehydration, and complaint of diarrhea for the last 3 days. Okay lets draw labs, and get a blood gas Na+ 134, K+ 2.9, Cl- 108, HCO3- 16, BUN 31, First figure out your blood gas/ ph = 7.32, CO2 = 34 HCO3= 15 (metabolic acidosis) I am thinking this is due to his history of diarrhea and the loss of bicarbonate because, the most common etiology of normal anion gap acidosis is diarrhea with renal tubular acidosis being a distant second Know your parameters Normal is 6-12 mEq/L (non anion is another way of saying it) Get familiar with what they could indicate Low (< 6) Hypoalbuminemia, Plasma cell dyscrasia, Monoclonal protein, Bromide intoxication Normal (6-12) Hyperalimentation, Acetazolamide and other carbonic anhydrase inhibitors, Renal tubular acidosis, D Continue reading >>

Review Easy Blood Gas Analysis: Implications For Nursing

Review Easy Blood Gas Analysis: Implications For Nursing

Introduction Arterial blood gas analysis is a common investigation in emergency departments and intensive care units for monitoring patients with acute respiratory failure. It also has some applications in general practice, such as assessing the need for domiciliary oxygen therapy in patients with chronic obstructive pulmonary disease. An arterial blood gas result can help in the assessment of a patient’s gas exchange, ventilatory control and acid–base balance [1]. However, the investigation does not give a diagnosis and should not be used as a screening test. It is imperative that the results are considered in the context of the patient’s symptoms. While non-invasive monitoring of pulmonary function, such as pulse oximetry, is simple, effective and increasingly widely used, pulse oximetry is no substitute for arterial blood gas analysis [2,3]. Pulse oximetry is solely a measure of oxygen saturation and gives no indication about blood pH, carbon dioxide or bicarbonate concentrations [4]. The arterial blood gas (ABG) is frequently used for monitoring the patient’s respiratory status and ABGs can be sampled as an arterial stab or by drawing blood from an arterial line. Knowledge about interpretation of ABGs is consequently essential for nurses who are working in ICU, to be able to analyze each component of the ABGs to avoid overlooking a change that could result in an inaccurate interpretation and lead to inappropriate treatment. All over the world nurses in ICU use considerable time in drawing, documenting, reporting and interpreting blood gases. Blood gases can be obtained from the arteries, veins or capillaries [1,3]. Arterial blood gases are analyzed with a great frequency. Nurses are usually involved in taking and analyzing the ABGs and normally they report t Continue reading >>

Etiology And Clinical Manifestations ::

Etiology And Clinical Manifestations ::

Etiology and Clinical Manifestations :: Metabolic Acidosis Etiology: Loss of base: such as in cases of severe diarrhea or Gain of metabolic acids: Anaerobic metabolism; Drug overdose (e.g.salicylates); Renal failure; Diabetic ketoacidosis Manifestations: headache and lethargy are early symptoms; warm flushed skin; seizures; mental confusion; muscle twitching; agitation; coma (severe acidosis); anorexia, nausea, vomiting and diarrhea; deep and rapid respirations (Kussmaul respirations); hyperkalemia (shift of acid to the ICF and K+ to the ECF); cardiac dysrhythmias. Decreased blood pH; decreased HCO3; normal PaCO2 or decreased if compensation is occurring. (The "nursing interventions" button on the homepage will lead the user to these nursing interventions listed under each problem. It would be nice to have a pull-down menu under "nursing interventions" for metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis) on the homepage). Nursing Interventions: Assess the clinical symptoms, health history, and lab results. Identify the underlying cause to intervene appropriately. When there is sever acidosis (pH < 7.1), sodium bicarbonate is necessary to bring the pH to a safe level. Correct the sodium and water deficits, as well. Metabolic Alkalosis Etiology: Loss of metabolic acids: such as in cases of prolonged vomiting or gastrointestinal suctioning. Hyperaldosteronism can cause sodium retention and loss of hydrogen ions and potassium. or Gain of Base: an increased intake of bicarbonate. Diuretics (e.g. furosemide) can cause sodium, potassium, and chloride excretion more than bicarbonate excretion. Manifestations: general weakness, muscle cramps, hyperactive reflexes, tetany (due to a decrease in calcium); shallow and slow respirations; confu Continue reading >>

Metabolic Acidosis/alkalosis

Metabolic Acidosis/alkalosis

-Gain of fixed acid ,inability to excrete acid, or loss of base. -Compensatory response of CO2 excretion by the lungs (Resp. Alkalosis) increase RR -Plasma pH increase -PaCO2 normal (uncompensated) -PaCO2 decrease (compensated) -HCO3 decrease -Urine pH <6 (compensated) Neuro Sign & Symptoms of Metabolic Acidosis? -Decrease BP -Dysrhythmias (related to hyperkalemia from compensation) -Warm, flushed skin (peripheral vasodilation) -Deep, rapid respiration (compensation by the lungs) a condition characterized by an excess of bicarbonate ions in the body in relation to the amount of carbonic acid in the body; the pH rises to greater than 7.45 -excessive vomiting -prolonged gastric suctioning -electrolyte disturbances (hypokalemia) -Cushings disease -excessive NaHCO3 intake -OD on baking soda -diuretics -excessive mineralocorticoids. -Compensatory response of CO2 retention by the lungs (Resp. Acidosis) decreased RR -Plasma pH increase -PaCO2 normal (uncompensated) -PaCO2 increase (compensated) -HCO3 increase -Urine pH >6 (compensated) -Dizziness -Irritability -Nervousness, confusion -Tachycardia -Dysrhythmias (related to hypokalemia from compensation) Neruomuscular S&S of Metabolic Alkalosis? -Tetany -Tremors -Tingling of finger and toes Muscle cramps , hypertonic muscle -Seizures -Hypoventilation (compensatory action by the lungs) Nursing interventions for Metabolic Acidosis? -Monitor VS -Neuro status -ABGs -K+ levels (elevated) -Make sure client has large-bore IV -Orient pt as needed -O2 as needed -position client to promote chest expansion -treat underlying cause -Resp. support (mechanical ventilation) -Give NaHCO3 Nursing intervention for Metabolic Alkalosis? -Assess I&O -LOC -HR & rhythm -VS -Assess neuro status -ABGs Continue reading >>

Metabolic Acidosis Treatment & Management: Approach Considerations, Type 1 Renal Tubular Acidosis, Type 2 Renal Tubular Acidosis

Metabolic Acidosis Treatment & Management: Approach Considerations, Type 1 Renal Tubular Acidosis, Type 2 Renal Tubular Acidosis

Metabolic AcidosisTreatment & Management Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN more... Treatment of acute metabolic acidosis by alkali therapy is usually indicated to raise and maintain the plasma pH to greater than 7.20. In the following two circumstances this is particularly important. When the serum pH is below 7.20, a continued fall in the serum HCO3- level may result in a significant drop in pH. This is especially true when the PCO2 is close to the lower limit of compensation, which in an otherwise healthy young individual is approximately 15 mm Hg. With increasing age and other complicating illnesses, the limit of compensation is likely to be less. A further small drop in HCO3- at this point thus is not matched by a corresponding fall in PaCO2, and rapid decompensation can occur. For example, in a patient with metabolic acidosis with a serum HCO3- level of 9 mEq/L and a maximally compensated PCO2 of 20 mm Hg, a drop in the serum HCO3- level to 7 mEq/L results in a change in pH from 7.28 to 7.16. A second situation in which HCO3- correction should be considered is in well-compensated metabolic acidosis with impending respiratory failure. As metabolic acidosis continues in some patients, the increased ventilatory drive to lower the PaCO2 may not be sustainable because of respiratory muscle fatigue. In this situation, a PaCO2 that starts to rise may change the plasma pH dramatically even without a significant further fall in HCO3-. For example, in a patient with metabolic acidosis with a serum HCO3- level of 15 and a compensated PaCO2 of 27 mm Hg, a rise in PaCO2 to 37 mm Hg results in a change in pH from 7.33 to 7.20. A further rise of the PaCO2 to 43 mm Hg drops the pH to 7.14. All of this would have occurred whi Continue reading >>

Acid-base Imbalances Nursing Care Plan & Management

Acid-base Imbalances Nursing Care Plan & Management

Acid-Base Imbalances Nursing Care Plan & Management Acidbase imbalance is an abnormality of the human bodys normal balance of acids and bases that causes the plasmapH to deviate out of the normal range (7.35 to 7.45). Respiratory Alkalosis is an acid-base imbalance characterized by decreased partial pressure of arterial carbon dioxide and increased blood pH Signs and Symptoms/ Clinical Manifestations: positive Chvosteks sign nausea and vomiting Labs indicated: arterial blood gas (ABG) studies reveal abnormal values: pH above 7.45 and partial pressure of carbon dioxide below 35 mmHg. Institute safety measures for the patient with vertigo or the unconscious patient. Encourage the anxious patient to verbalize fears Administer sedation as ordered to relax the patient Encourage the patient to take deep, slow breaths or breathe into a brown paper bag (inspire CO2). Monitor ABGs, primarily PaCO2; a value less than 35 mmHg indicates too little CO2 (carbonic acid) Respiratory Acidos is is an acid-base imbalance characterized by increased partial pressure of arterialcarbon dioxide and decreased blood pH. chest wall trauma, pulmonary edema, atelactasis, pneumothorax, drug overdose, pneumonia, Guillain-Barre syndrome any condition that results in hypoventilation Signs and Symptoms/ Clinical Manifestations: mental cloudiness and feeling of fullness in head Labs indicated: arterial blood gas (ABG) studies reveal abnormal values: pH below 7.35 and partial pressure of carbon dioxide above 45 mmHg. Monitor I&O and administer fluids as ordered Administer oxygen and medications for order; monitor hourly vital signs and respiratory status (may requires mechanical ventilation) Monitor arterial blood gases (ABGs); pH, PaCO2, HCO3 Metabolic Alkalosis is an acid-base imbalance characterized b Continue reading >>

Using The Abg To Identify Acidosis

Using The Abg To Identify Acidosis

March/April 2016, Volume :14 Number 2 , page 6 - 9 [Free] Join NursingCenter to get uninterrupted access to this Article Acidosis is an acid-base imbalance that's characterized by an abnormal accumulation of acid in the blood. It can also be caused by a loss of alkali in the blood, leading to an acid-base mismatch in which there's more acid than base. Regardless of the cause, acidosis will lead to a serum pH level below 7.35. An acidic environment can be very dangerous because it alters cellular function, which in turn affects all body systems. Additionally, acidosis can alter a patient's oxygenation by making it more difficult for hemoglobin to bind with available oxygen. Acidosis is either respiratory or metabolic in nature. In this article, you'll learn about both disorders, including recognition, causes, and nursing care. As the name implies, respiratory acidosis is caused by problems with the respiratory system. In order to understand respiratory acidosis, you'll need to have a generalized understanding of anatomy and physiology as it relates to the respiratory system, which takes oxygen from the air and transports it to the blood. Once oxygen is in the blood, it's transported throughout the body. In addition to taking in oxygen, the lungs also remove carbon dioxide from the blood by exhaling it into the environment. When the lungs aren't able to remove carbon dioxide effectively, the carbon dioxide that remains in the body will form an acid. This acid accumulates in the blood, causing a low serum pH and corresponding respiratory acidosis. Respiratory acidosis can develop quickly over a short period of time or slowly over a prolonged amount of time. The speed with which respiratory acidosis develops will depend on the underlying condition causing it. Respiratory a Continue reading >>

Acid-base Management: Metabolic Acidosis | Definition Of Acid-base Management: Metabolic Acidosis By Medical Dictionary

Acid-base Management: Metabolic Acidosis | Definition Of Acid-base Management: Metabolic Acidosis By Medical Dictionary

Acid-base management: metabolic acidosis | definition of acid-base management: metabolic acidosis by Medical dictionary the process of controlling how something is done or used. acid-base management in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from acid-base imbalance. acid-base management: metabolic acidosis in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from serum bicarbonate levels lower than desired. See also metabolic acidosis . acid-base management: metabolic alkalosis in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from serum bicarbonate levels higher than desired. See also metabolic alkalosis. acid-base management: respiratory acidosis in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from serum pCO2 levels higher than desired. See also respiratory acidosis . acid-base management: respiratory alkalosis in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from serum pCO2 levels lower than desired. See also respiratory alkalosis. airway management in the nursing interventions classification, a nursing intervention defined as insertion or assisting with insertion and stabilization of an artificial airway . See also artificial airway management . allergy management in the nursing interventions classification, a nursing intervention define Continue reading >>

Metabolic Acidosis Nursing Care Plan

Metabolic Acidosis Nursing Care Plan

Arteriolar dilation or decreased cardiac contractility and hypovolemia occur, resulting in systemic shock, evidenced by hypotension and tissue hypoxia. Assess LOC and note progressive changes in neuromuscular status. Note neuromuscular strength, tone, movement. Decreased mental function, confusion , seizures, weakness, flaccid paralysis can occur because of hypoxia, hyperkalemia , and decreased pH of CNS fluid. Provide seizure or coma precautions and bed in low position, use of side rails, frequent observation. Protects patient from injury resulting from decreased mentation and convulsions. Acidemia may be manifested by changes in ECG configuration and presence of brady dysrhythmias as well as increased ventricular irritability such as fibrillation (signs of hyperkalemia ). Life-threatening cardiovascular collapse may also occur because of vasodilation and decreased cardiac contractility. Note: Hypokalemia can occur as acidosis is corrected, resulting in premature ventricular contractions (PVCs) and/or ventricular tachycardia. Observe for altered respiratory excursion, rate, and depth. Deep, rapid respirations (Kussmauls) may be noted as a compensatory mechanism to eliminate excess acid; however, as potassium shifts out of cell in an attempt to correct acidosis, respirations may become depressed. Transient respiratory depression may be the result of overcorrection of metabolic acidosis with sodium bicarbonate. Assess skin temperature, color, capillary refill. Evaluates circulatory status, tissue perfusion , effects of hypotension . Auscultate bowel sounds, measure abdominal girth as indicated. In the presence of coexisting hyperkalemia , GI distress (distension, diarrhea , and colic) may occur. Marked dehydration may be present because of vomiting, diarrhea . Therapy n Continue reading >>

Metabolic Acidosis: Pathophysiology, Diagnosis And Management: Diagnosis Of Metabolic Acidosis

Metabolic Acidosis: Pathophysiology, Diagnosis And Management: Diagnosis Of Metabolic Acidosis

Recommendations for the treatment of acute metabolic acidosis Gunnerson, K. J., Saul, M., He, S. & Kellum, J. Lactate versus non-lactate metabolic acidosis: a retrospective outcome evaluation of critically ill patients. Crit. Care Med. 10, R22-R32 (2006). Eustace, J. A., Astor, B., Muntner, P M., Ikizler, T. A. & Coresh, J. Prevalence of acidosis and inflammation and their association with low serum albumin in chronic kidney disease. Kidney Int. 65, 1031-1040 (2004). Kraut, J. A. & Kurtz, I. Metabolic acidosis of CKD: diagnosis, clinical characteristics, and treatment. Am. J. Kidney Dis. 45, 978-993 (2005). Kalantar-Zadeh, K., Mehrotra, R., Fouque, D. & Kopple, J. D. Metabolic acidosis and malnutrition-inflammation complex syndrome in chronic renal failure. Semin. Dial. 17, 455-465 (2004). Kraut, J. A. & Kurtz, I. Controversies in the treatment of acute metabolic acidosis. NephSAP 5, 1-9 (2006). Cohen, R. M., Feldman, G. M. & Fernandez, P C. The balance of acid base and charge in health and disease. Kidney Int. 52, 287-293 (1997). Rodriguez-Soriano, J. & Vallo, A. Renal tubular acidosis. Pediatr. Nephrol. 4, 268-275 (1990). Wagner, C. A., Devuyst, O., Bourgeois, S. & Mohebbi, N. Regulated acid-base transport in the collecting duct. Pflugers Arch. 458, 137-156 (2009). Boron, W. F. Acid base transport by the renal proximal tubule. J. Am. Soc. Nephrol. 17, 2368-2382 (2006). Igarashi, T., Sekine, T. & Watanabe, H. Molecular basis of proximal renal tubular acidosis. J. Nephrol. 15, S135-S141 (2002). Sly, W. S., Sato, S. & Zhu, X. L. Evaluation of carbonic anhydrase isozymes in disorders involving osteopetrosis and/or renal tubular acidosis. Clin. Biochem. 24, 311-318 (1991). Dinour, D. et al. A novel missense mutation in the sodium bicarbonate cotransporter (NBCe1/ SLC4A4) Continue reading >>

Management Of Diabetic Ketoacidosis In Adults

Management Of Diabetic Ketoacidosis In Adults

Diabetic ketoacidosis is a potentially life-threatening complication of diabetes, making it a medical emergency. Nurses need to know how to identify and manage it and how to maintain electrolyte balance Continue reading >>

More in ketosis