Alkalosis
An acid-base imbalance in which blood pH exceeds 7.45, caused by loss of acid or gain of base.
Expect a values-to-cause ABG item: the stem hands you pH, PaCO2, and HCO3, you label the disturbance, then pick the priority. The reliable tell is direction — when PaCO2 and HCO3 move the SAME way as each other, it’s compensation, not a second problem (they move opposite ways in a mixed disorder). A near-normal pH with abnormal gases means fully compensated. The classic vomiting/NG-suction stem hides a trap: that patient also loses chloride and potassium (renal K+ wasting via aldosterone), so the priority is often to monitor for hypokalemia — flat T waves, U waves, dysrhythmias — not just “give an antiemetic.”
Don’t confuse the symptom with the value. Tingling and Chvostek/Trousseau signs come from low ionized calcium, which falls because the higher pH makes albumin bind more calcium — total calcium is unchanged. Contrast with acidosis (pH below 7.35; Kussmaul breathing in the metabolic type) and recall that homeostasis here is negative feedback at work. ROME — Respiratory Opposite, Metabolic Equal — keeps the pH/PaCO2/HCO3 directions straight.
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