Sodium Bicarbonate Drug Study

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					    NAME OF DRUG             CLASSIFICATION            MECHANISM OF ACTION                      INDICATION          CONTRAINDICATION                   ADVERSE EFFECTS                               NURSING RESPONSIBILITIES

GENERIC NAME:                Fluids & Electrolytes   Restores buffering capacity of the   • Cardiac Arrest         • Contraindicated in patients     CNS:                             BEFORE:
sodium bicarbonate              Balance Drugs        body and neutralizes excess acid.    • Metabolic Acidosis       with metabolic or               tetany                            1) Determine previous hypersensitivity to drugs & antacids.
                                  (Acidifiers)                                            • Systemic or Urinary      respiratory alkalosis in        CV:                               2) Assess abdominal bowel sounds, to ensure GI motility.
TRADE NAME:                           &                                                     alkalinization           those with hypocalcemia in      edema                             3) Assess mucous membrane status to evaluate potential
Arm & Hammer Baking              (Alkalinizers)                                           • Antacid                  which alkalosis may             GI:                                  problems with absorption.
Soda, Neut, Soda Mint                                                                                                produce tetany,                 gastric distention, belching,     4) Screen for electrolyte disturbances that could be exacerbated
                                                                                                                     hypertension, seizures, or      flatulence                           by the effects of the drug & pregnancy and lactation which
MAXIMUM DOSE:                                                                                                        heart failure                   METABOLIC:                           could require caution.
2-5mEq / kg IV, 4-8 hours                                                                                          • Also contraindicated in         Hypokalemia, metabolic            5) Screen for baseline data vital signs.
infusion                                                                                                             patients who are losing         alkalosis, hypernatremia,
                                                                                                                     chlorides because of            hyperosmolarity with             DURING:
MINIMUM DOSE:                                                                                                        vomiting or continuous GI       overdose                          1) Administer the drug apart from any other oral medications.
0.5mEq / kg every 10                                                                                                 suction & in those              SKIN:                             2) Have patient chew tablets (PO) thoroughly and follow with
minutes                                                                                                              receiving diuretics that        Pain & irritation at injection       water.
                                                                                                                     produce hypochloremic           site                              3) Periodically monitor serum electrolyte.
AVAILABILITY:                                                                                                        alkalosis. Oral sodium                                            4) Assess patients for any signs of acid-base or electrolyte
Injection:                                                                                                           bicarbonate is                                                       imbalance.
4% (2.4mEq / 5mL)                                                                                                    contraindicated for patients                                      5) Administer direct IV push in arrest situation. Doses should
4.2% (5mEq / 10mL), 5%                                                                                               with acute ingestion of                                              be based on ABG results.
(297.5mEq/500mL)                                                                                                     mineral acids
7.5% (8.92 mEq/10mL &                                                                                              • Use with extreme caution                                         AFTER:
44.6mEq/50mL), 8.4%                                                                                                  in patients with renal                                            1) Instruct patient to take medication as prescribed.
(10meq/10mL &                                                                                                        insufficiency, heart failure,                                     2) Review symptoms of electrolyte imbalance with patients on
50mEq/50mL)                                                                                                          or other edematous or                                                chronic therapy.
Tablets: 325mg, 650mg                                                                                                sodium-retaining condition                                        3) Advise patient not to take milk products concurrently with
                                                                                                                                                                                          this medication.
CONTENT:                                                                                                                                                                               4) Advise patient to avoid routine use of sodium bicarbonate for
sodium bicarbonate                                                                                                                                                                        indigestion.
                                                                                                                                                                                       5) Instruct patient to notify nurse for signs of hypersensitivity to
PATIENT’S DOSE:                                                                                                                                                                           drug.
No specific patient

SOURCE:                     SOURCE:                  SOURCE:                              SOURCE:                 SOURCE:                            SOURCE:                          SOURCE:
NDH 2005 p. 880             NDH 2005 p. 880          NDH 2005 p. 880                      NDH 2005 p. 880         NDH 2005 p. 881                    NDH 2005 p. 880                  Davis Drug Guide p. 472

                                                                                                                                                                                                                                HERBERT ALMENDRAS HUYO

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