Correction of metabolic alkalosis may involve which of the following? 1. Restoring normal fluid volume 2. Administering acidifying agents 3. Restoring normal K+ and Cl? levels

a. 3 only
b. 1 and 2 only
c. 2 and 3 only
d. 1, 2, and 3

ANS: D
Correction of metabolic alkalosis is aimed at restoring normal fluid volume and electrolyte con-centrations, especially K+ and Cl− levels. Inadequate fluid volume, especially if coupled with hypochloremia, causes excessive secretion and loss of H+ and K+ ions because of the great need to reabsorb Na+ ions. Thus, in treating this type of alkalosis, it is important to supply adequate fluids containing Cl− ions. If hypokalemia is a primary factor, then KCl is the preferred corrective agent. In cases of severe metabolic alkalosis, acidifying agents, such as dilute hydrochloric acid or ammonium chloride may be infused directly into a large central vein.