Acid Balance; Giddens CHARTS Flashcards
Too much carbonic acid (respiratory acidosis)….. RESP/RENAL RESPONSE
RESP RESP
Cause:
Hypoventilation
Correction:
Hyperventilation
RENAL RESP
Compensation:
Increased secretion of H+ More NH3 production
Too little carbonic acid (respiratory alkalosis)…… RESP/RENAL RESPONSE
RESP RESP
Cause:
Hyperventilation
Correction:
Hypoventilation
RENAL RESP
Compensation:
Decreased secretion of H+
Less NH3 production
Too much metabolic acid
(metabolic acidosis)…. RESP/RENAL RESP
RESP RESP
Compensation: Hyperventilation
Cause:
More metabolic acid than kidneys can excrete
RENAL RESP
Correction:
Increased secretion of H+
More NH3 production
Too little metabolic acid
(metabolic alkalosis)…. RESP/RENAL RESP
RESP RESP
Compensation:
Hypoventilation
Cause:
More bicarbonate than kidneys can excrete (too little metabolic acid)
RENAL RESP
Correction:
Decreased secretion of H+
Less NH3 production
TOO MUCH CARBONIC ACID (RESPIRATORY ACIDOSIS)….. CLINICAL FINDINGS
Headache
Decreased LOC
Hypoventilation (cause of problem)
Cardiac dysrhythmias
If severe: hypotension
TOO MUCH METABOLIC ACID (METABOLIC ACIDOSIS)….. CLINICAL FINDINGS
Decreased LOC Hyperventilation (compensatory mechanism)
Abdominal pain
Nausea and vomiting
Cardiac dysrhythmias
TOO LITTLE CARBONIC ACID (RESPIRATORY ALKALOSIS)
Excitation and belligerence, lightheadedness, unusual behaviors; followed by decreased LOC if severe
Perioral and digital paresthesias, carpopedal spasm, tetany
Diaphoresis
Hyperventilation (cause of problem)
Cardiac dysrhythmias
TOO LITTLE METABOLIC ACID (METABOLIC ALKALOSIS)
Excitation followed by decreased LOC if severe
Perioral and digital paresthesias, carpopedal spasm
Hypoventilation (compensatory mechanism)
Signs of volume depletion and hypokalemia if present
ROME (acronym)
Respiratory Opposite
Metabolic Equal
Respiratory Opposite
pH LOW
CO2 HIGH
or
pH High
CO2 LOW
Metabolic Equal
pH LOW
CO2 LOW
or
pH HIGH
CO2 HIGH
FRAMEWORK FOR NURSING INTERVENTIONS FOR PEOPLE WITH DISRUPTED ACID-BASE BALANCE
Provide safety and comfort. Support compensatory mechanisms. Administer collaborative interventions: Treatment of the underlying cause Adjustment of the pH (controversial) Monitor for complications of therapy. Teach how to avoid in the future (if appropriate) or when to seek help (if chronic).
