Sodium Bicarbonate Nursing Responsibilities

Information on Sodium Bicarbonate

Brand Name: Bakin Soda, Bell-Ans, Citrocarbonate, Neut, Soda Mint

Classification: antiulcer agents, alkalinizing agent


  1. Management of metabolic acidosis
  2. Used to alkalinize urine and promote excretion of certain drugs in over dosage situations
  3. Used as an antacid


Sodium Bicarbonate acts as an alkalinizing agent by releasing bicarbonate ions. Following oral administration of this medication, it releases bicarbonate which is capable of neutralizing gastric acid.


  1. Metabolic or respiratory alkalosis
  2. Hypocalcemia
  3. Excessive chloride loss
  4. It is not recommended as an antidote following ingestion of strong mineral acids
  5. Patients on sodium restricted diet
  6. Renal failure
  7. Severe abdominal pain of unknown cause especially if associated with fever

Used cautiously in patients with:

  1. Congenital heart failure
  2. Concurrent corticosteroid therapy
  3. Children with diabetic ketoacidosis because taking sodium bicarbonate may increase the risk of cerebral edema
  4. Chronis use as an antacid because it may result to metabolic alkalosis and possible sodium overload

Side effects

  1. Edema
  2. Flatulence
  3. Gastric distention
  4. Metabolic alkalosis
  5. Hypernatremia
  6. Hypocalcemia
  7. Hypokalemia
  8. Sodium and water retention
  9. Irritation at IV site
  10. Tetany

Nursing Responsibilities

  1. Assess the client’s fluid balance throughout the therapy. This assessment includes intake and output, daily weight, edema and lung sounds.
  2. Symptoms of fluid overload should be reported such as hypertension, edema, difficulty breathing or dyspnea, rales or crackles and frothy sputum.
  3. Sigs of acidosis should be assessed such as disorientation, headache, weakness, dyspnea and hyperventilation.
  4. Assess for alkalosis by monitoring the client for confusion, irritability, paresthesia, tetany and altered breathing pattern.
  5. Hypernatremia clinical manifestations should be assessed and monitored which includes: edema, weight gain, hypertension, tachycardia, fever, flushed skin and mental irritability.
  6. Hypokalemia should also be assessed by monitoring signs and symptoms such as: weakness, fatigue, U wave on ECG, arrhythmias, polyuria and polydipsia.
  7. IV sites should be observed closely. Extravasation should be avoided as tissue irritation or cellulitis may occur when taking sodium bicarbonate.
  8. If infiltration occurs, the physician should be notified immediately. Confer with the doctor or other health care staff regarding warm compresses and infiltration site with lidocaine or hyaluronidase.
  9. Monitor the client’s serum calcium, sodium, potassium, bicarbonate concentrations, serum osmolarity, acid-base balance and renal function before and throughout the therapy.
  10. Tablets must be taken with a full glass of water.
  11. For clients taking the medication as a treatment for peptic ulcers it may be administered 1 and 3 hours after meals and at bedtime.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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