Question

A charge nurse is teaching a group of new nurses about conditions related to Metabolic Alkalosis. Which of the following statements by one of the new nurse indicates understanding?

Select one:

a. "Metabolic alkalosis can occur with excessive use of potassium-losing diuretics."

b. "Metabolic alkalosis can occur due to diabetes mellitis."

c. "Metabolic alkalosis can occur in a client who has sustained a brainstem injury."

d. "Metabolic alkalosis can occur from salicylate overdose."

Answer 1

a) Metabolic alkalosis can occur with excessive use of potassium-losing diuretic.

Metabolic alkalosis can occur secondary to loop diuretic use in a few ways. One is due to increased distal delivery of sodium ions. As sodium travels through the urinary system it eventually reaches the distal tubules and encounters the aldosterone-sensitive sodium channel. This pump exchanges sodium ions for hydrogen ions, the loss of which can lead to alkalosis. This same pump also exchanges sodium ions for potassium ions, leading to hypokalemia. Metabolic alkalosis can also occur secondary to loop diuretic induced hypochloremia. Negatively charged chloride ions leave the body disproportionately to any positively charged counterparts. The body begins to produce bicarbonate (HCO3-) to replace the lost anions and an alkalosis develops.