OVERVIEW
OVERVIEW
Hypokalemic alkalosis is a compensated or decompensated alkalosis accompanied by a decrease in blood potassium and blood chloride. It is common in certain digestive and neurological disorders or after treatment with potassium-removing diuretics and hormonal drugs. It is also seen in Cushing’s syndrome and primary aldosteronism.
Whether medical insurance
Yes
Department
Emergency Department
Clinical Symptoms
Shallow, slow breathing, headache, dizziness, weakness, restlessness, delirium, thirst, oliguria, numbness in hands and feet.
Hazards
Severe cases can lead to coma due to lack of oxygen.
Complications
Hypocalcemia, etc.
Examination
Physical examination, serum electrolyte measurement, blood gas analysis, electrocardiogram, etc.
Diagnosis
Diagnosis is made on the basis of medical history, serum electrolyte measurement, blood gas analysis and electrocardiogram.
Principles of treatment
Treat the primary disease, avoid excessive alkali intake, supplement potassium chloride, and choose reasonable drugs according to the etiology.
Curability
Aggressive treatment may improve the symptoms.
Dietary recommendations
Normal diet, appropriate supplementation of potassium and calcium.
Etiology
Etiology
Often caused by digestive or neurological disorders or certain medications.
Symptoms and Diagnosis
Typical Symptoms
Clinical manifestations include headache, dizziness, fatigue, restlessness, delirium, thirst, oliguria, often accompanied by muscle weakness, numbness of hands and feet, indifference, decreased appetite, abdominal distension, nausea, constipation, and tetany.
Diagnostic basis
1. Medical history
There is often a history of gastrointestinal diseases such as vomiting or the application of certain drugs.
2. Symptoms
Headache, dizziness, fatigue, agitation, delirium, decreased skin elasticity, thirst, oliguria, numbness of hands and feet.
3.Auxiliary examination
(1) Serum electrolyte measurement: serum potassium and chloride concentration is lower than normal.
(2) Blood gas analysis: pH rises, HCO3-, BE, SB, TCO2, etc. increase bicarbonate ion level rises,
(3) Electrocardiogram: the earliest manifestation is ST-segment depression, T-wave depression, widening, inversion, the appearance of δ-wave, Q-T time prolongation.
Treatment
Treatment guidelines
Supplement potassium chloride and choose reasonable drugs according to the etiology.
Drug treatment
1. Potassium chloride is the main drug, oral in mild cases, intravenous in severe cases; it is advisable to pay attention to renal function and actual urine output when supplementing potassium salt.
2. Patients with severe alkalosis should be treated with symptomatic treatment such as potassium and chlorine supplementation, etc. If there is no improvement after treatment, arginine hydrochloride, dilute hydrochloric acid or ammonium chloride can be used.
3. After a large amount of diuresis, sodium and water loss can be accompanied by chlorine loss, which can be supplemented with sodium chloride solution.
4. If the convulsion is caused by alkalemia, calcium can be supplemented. At the same time, attention should be paid to the supplementation of magnesium.
Other treatments
Actively treat the primary disease.
Prognosis
Active treatment can improve the prognosis.
Nursing care
Daily care
1. Environment and rest
Keep the environment quiet and tidy, ventilate every day, avoid bright light stimulation, etc.; live a regular life and ensure enough sleep.
2. Medication instruction
Adhere to the medication prescribed by the doctor, do not increase, decrease or stop the medication by yourself.
3. Review
After discharge from the hospital, follow the doctor’s instructions to review electrolytes regularly, if you find symptoms such as numbness and weakness of the limbs or adverse drug reactions, consult the doctor promptly.
Dietary management
Normal diet, appropriate supplementation of calcium.