NREMT Paramedic Practice

Which symptom is characteristic of Metabolic Alkalosis?

1. Hyperkalemia

2. Mild respiratory distress

3. Weakness and confusion

4. Increased muscle reflexes

The correct answer is: Weakness and confusion

Weakness and confusion are indeed characteristic symptoms of metabolic alkalosis. In this state, there is an increased concentration of bicarbonate in the blood, which can lead to changes in the body's normal chemistry and, subsequently, affect neurological function. The elevated pH can interfere with normal cellular activity, causing symptoms such as muscle weakness and altered mental status, which often includes confusion. In metabolic alkalosis, the body's pH rises above the normal range, and this can result in reduced calcium availability in the blood due to its binding to proteins. Lower levels of ionized calcium can affect neuromuscular excitability, leading to weakness and confusion, particularly because the brain is highly sensitive to even minor changes in the acid-base balance. This option effectively captures the neurological and muscular impacts of metabolic alkalosis, making it the best choice among the given symptoms. In contrast, conditions such as hyperkalemia are more associated with metabolic acidosis, mild respiratory distress does not strongly correlate with metabolic alkalosis specifically, and increased muscle reflexes could be related to other conditions rather than being a direct symptom of metabolic alkalosis.