Page 285 - Saunders Comprehensive Review For NCLEX-RN

Clinical Manifestations of Alkalosis

Adapted from Lewis S, Bucher L, Heitkemper M, Harding, M, Kwong J, Roberts D:
Medical-surgical nursing: assessment and management of clinical problems, ed 10, St.
Louis, 2017, Mosby.

Box 9-3

Causes of Metabolic Acidosis

▪ Diabetes mellitus or diabetic ketoacidosis: An insufficient supply of insulin
causes increased fat metabolism, leading to an excess accumulation of ketones
or other acids; the bicarbonate then ends up being depleted.
▪ Excessive ingestion of acetylsalicylic acid: Causes an increase in the hydrogen
ion concentration.
▪ High-fat diet: Causes a much too rapid accumulation of the waste products of fat
metabolism, leading to a buildup of ketones and acids.
▪ Insufficient metabolism of carbohydrates: When the oxygen supply is not
sufficient for the metabolism of carbohydrates, lactic acid is produced and lactic
acidosis results.
▪ Malnutrition: Improper metabolism of nutrients causes fat catabolism, leading to
an excess buildup of ketones and acids.
▪ Renal insufficiency, acute kidney injury, or chronic kidney disease: Increased

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