Metabolic Alkalosis on the NCLEX
Causes (vomiting, diuretics), saline-responsive vs not.
Metabolic alkalosis is high pH from non-respiratory cause.
ABG pattern
pH >7.45, HCO3 >26.
Causes
Vomiting (loss of HCl), NG suctioning, diuretics, hyperaldosteronism, severe hypokalemia, milk-alkali.
Treatment
Saline (most causes are saline-responsive, volume depleted). Replace K+ and Cl-. Treat underlying.
Frequently asked
Hyperaldosteronism, saline responsive?
No. Need to treat aldosterone excess.
Vomiting and metabolic alkalosis?
Loss of H+. Volume depletion drives kidney to retain HCO3.
Quick check
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