Patients with this metabolic condition display increased arterial pH values above 7.45, alkalizing the blood.
In metabolic alkalosis, bicarbonate levels are increased to levels above 26. This occurs because there is a decreased hydrogen ion concentration, as acid is lost.
Patients may display signs of excitability, particularly with the nervous system. This may manifest as hyperactive reflexes, irritability, increased activity and anxiety. Etiologies for these symptoms may relate to low ionized plasma calcium in metabolic alkalosis.
Cardiac arrhythmias may develop with this condition, as alkalosis leads to hypokalemia. Severe alkalosis can predispose to refractory arrhythmias by reducing coronary flow as well.
Paresthesias, which include the sensations of prickling and tingling of the skin, can occur with metabolic alkalosis.
Due to muscle dysfunction and electrolyte imbalances which may occur with metabolic alkalosis, patients can display muscle cramps. Spasms may also occur from smooth muscle dysfunction.
A sign of untreated metabolic alkalosis, seen later in the course of this disorder, is muscle weakness, which is due to skeletal muscle dysfunction. This stems from electrolyte dysfunction, such as hypokalemia, which can accompany metabolic alkalosis.
As muscle weakness progresses in patients, decreased respiratory effort may be seen in patients with prolonged metabolic alkalosis. It is important to monitor patient respiratory status and those with severe alkalosis should be considered for mechanical breathing intervention.
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