Metabolic Alkalosis: The Forgotten Acid-Base Imbalance

Up My Nursing Game

Metabolic Alkalosis: The Forgotten Acid-Base Imbalance

September 25, 2023

Metabolic Alkalosis: The Forgotten Acid-Base Imbalance

We often draw blood gasses looking for an ACIDosis, but what about when you discover an ALKAlosis?

In this episode, I share a story of a patient with a history of CHF, admitted for diuresis. She was initially improving but becames lethargic and difficult to arouse. We were surprised when her VBG showed alkalosis instead acidosis. Guest Sarah Lorenzini from the Rapid Response RN podcast, helped me make sense of our finding.

Listen in to learn about this rare acid base imbalance that can occur as a result of a very common intervention.

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See the show notes at

The key moments in this episode are:

00:02:32 – Patient background and presentation
00:15:14 – Causes of metabolic alkalosis 
00:20:18 – Treatment of diuretic induced metabolic alkalosis, 
00:27:12 – Diagnostic reasoning, antibiotic stewardship 

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