Correction of metabolic alkalosis may involve which of the following? 1. Restoring normal fluid ...

(Answer to Q. 1)  ANS: D
Correction of metabolic alkalosis is aimed at restoring normal fluid volume and electrolyte con-centrations, especially K+ and Cl levels. Inadequate fluid volume, especially if coupled with hypochloremia, causes excessive secretion and loss of H+ and K+ ions because of the great need to reabsorb Na+ ions. Thus, in treating this type of alkalosis, it is important to supply adequate fluids containing Cl ions. If hypokalemia is a primary factor, then KCl is the preferred corrective agent. In cases of severe metabolic alkalosis, acidifying agents, such as dilute hydrochloric acid or ammonium chloride may be infused directly into a large central vein.

(Answer to Q. 2)  ANS: A
A normal BE is 2 mEq/L. A positive BE (>+2 mEq/L) indicates a gain of base or loss of acid from nonrespiratory causes. A negative BE (<2 mEq/L) indicates a loss of base or a gain of acid from nonrespiratory causes.

(Answer to Q. 3)  ANS: D
To eliminate the influence of the hydration reaction on plasma bicarbonate concentration, some laboratories report standard bicarbonate.

(Answer to Q. 4)  ANS: A
As all the ABG values are within normal limits the gas must be normal.

(Answer to Q. 5)  ANS: A
The patient is alkalotic (pH >7.35). This can be caused by an elevated HCO3 or a low PCO2. In this question the HCO3 is elevated. If compensation were present the PCO2 would have to be elevated. As it is normal, this is an uncompensated metabolic alkalosis.

(Answer to Q. 6)  ANS: C
The patient's pH is normal so either the gas is normal or fully compensated. As the PCO2 and HCO3 are both low, a fully compensated state exists. As the pH is on the high side of normal the fully compensated disorder would be alkalosis. This would be caused by a low PCO2 or a high HCO3. In this case a low PCO2. The low HCO3 is compensating for this respiratory alkalosis.