You mention gastrointestinal fluid loss in the comments
regarding your question. I will assume the acid-base disturbance is caused by either
intractable nausea/vomiting or massive diarrheal stools. Naso-gastric tube suctioning
could also be a cause. First, we must treat the etiology of the gastrointestinal fluid
loss. If the patient is experiencing intractable nausea/vomiting, then medications and
or IV fluids should be promptly given to cease the emesis. If the patient is having
massive diarrheal stools, IV fluids must be given and a stool culture obtained to rule
out an infectious cause of the diarrhea. There are a few medications that are seldom
given for this scenario, mainly sodium bicarbonate, but the etiology of the GI fluid
loss must be ascertained and corrected.
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