pH7.0 bicarbonate - GrepMed

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#IntracellularFluid #ICF #MajorAnions #Phosphate #MajorCations #Potassium #Magnesium #pH7.0 #ExtracellularFluid #ECF #MajorAnions #Chloride #Bicarbonate #MajorCations #Sodium #pH7.4

Potassium #Magnesium #pH7.0 ... MajorAnions #Chloride #Bicarbonate ... MajorCations #Sodium #pH7.4

#Bicarbonate #algorithm #differential

#Bicarbonate #algorithm

ECG Changes in Hyperkalemia and Treatment
Membrane Stabilization
- Calcium gluconate or chloride
Redistribution
- Insulin

Albuterol - Sodium bicarbonate

Approach to Elevated Bicarbonate (HCO3)
Risk Factors for Hypercapnea? (Hx of COPD, OSA, sedative use, CNS/muscular disorders?)
(+)

Approach to Elevated Bicarbonate ... UnremarkableLab #Bicarbonate

Causes of Metabolic Acidosis - Gap and Non-Gap - Differential Diagnosis Algorithm
• Elevated Anion Gap

(<14) (Loss of Bicarbonate

Renal Tubular Acidosis (RTA)
Type 1 - Failure of secretion
Type 2 - Bicarbonate wasting
Type 4 -

secretion Type 2 - Bicarbonate

Hyperkalemia Management
Membrane Stabilizers:
• Calcium gluconate
Shifters:
• Insulin + glucose
• Albuterol
Excreters:
• Furosemide
• Sodium

Furosemide • Sodium bicarbonate

Phosphate Binders - Pros and Cons

Calcium carbonate (TumsTM)
- Most inexpensive, antacid properties useful for

Cons Calcium carbonate ... compared to Ca carbonate ... Sevelamer Carbonate ... Lanthanum Carbonate

Nephron Remodeling as a Mechanism of Diuretic Resistance. When high doses of loop diuretics are used

and the chloride–bicarbonate

Hyperkalemia Treatment Options
Stabilize cardiac membrane:
• IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
• IV Fluids
Shift

minutes) • Sodium bicarbonate

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