acid base and electrolyte imbalance Flashcards
for cells to function optimally
metabolic processes must maintain a steady balance between acids and bases found in the body
acid-base represents
homeostasis of hydrogen (H+) ion concenter in body fluids
hydrogen shifts
between extracellular and intracellular compartments to compensate for acid-base imbalance
minor changes in hydrogen have
major effects on normal cellular function
ABG
the needle goes into the artery to check how well lungs works
arterial ph is an
indirect measurement of hydrogen ion concentration and is a result of respiratory and kidney compensation function
arterial blood is
most commonly used to evaluate acid base balance
the ph is the expression of the
balance between carbon dioxide (C02), which is regulated by the lungs, and bicarbonate (HC03) base regulayed by kidneys
compensation
refers to the process by which body attemps to correct changes and imbalances in ph levels
full compensation
occurs when ph level of blood returns to normal (7.35-7.45)
if ph level is not able to normalize
partial compensation
acid base imbalances are
result of insufficient compensation
respiratory and kidney function play a
a large role in the body’s ability to effectively compensate for acid-base alterations
organ dysfunction negatively
affects acid base compensation
less than 7.35
acidosis
greater than 7.45
identify as alkalosis
identify PaCO2 less than 35 or greater than 45
respiratory in orgin
identify HCO3 less than 22 or greater than 26 mEq/L
metabolic in orgin
evaluate the pa02 and Sa02 if results are less than the expected client is
hypoxic
uncompensated
ph is outside the expected reference range. and either HCO3 OR PACO2 IS outside the expected reference range
fully compensated
ph is within the expected reference range, but PaCo2 and HCO3 are both outside the expected range
ph is less than 7.40
acidosis
ph greater than 7.40
alkalosis
electrolytes
minerals in body that can conduct electricity
where are electrolytes found
urine, blood, tissues, as well as other body fluids
- as well as food, drinks, and supplementd
specific electrolytes
potassium
sodium
calcium
magnesium
electrolytes are responsible for
- balancing the amount of water in body
- balancing the bodys ph
- moving waste out of body cells
- moving nutrients into body cells
- allowing body muscles heart, nerves, and brain to function properly
average persons weight is
1/2 to 2/3 water
- crucial to maintaining the balance of water in body
dehydration
person is unable to drink enough fluids to compensate for excess water loss
thirst
results from nerve centers in brain being stimulated when body needs water
vasopressin
stimulated in order to conserve water from pituitary gland
- stimulates kidneys to excrete less urine which helps to conserve water
what can lead to electrolyte imbalance
dehydration overhydration certain medications history of heart kidney liver disorder incorrect intravenous fluids or feedings
potassium levels
3.5- 5.1 meq/l
sodium
135-145 meq/l
calcium
8.5-10.5 mg/dl
magnesium
1.8-2.2
potassium role
helps with nerve and muscle cell function while playing an important role in muscle cells in heart
sodium role
- supports the function of nerves and mucles
- helps maintain a normal blood pressure
calcium role
- help the body maintain strong bones and is mostly stores in teeth and bones to support their hardness
- also helps muscles move nerves to carry a message between the brain and body and blood vessels to move blood throughout the body
magnesium role
assist in the regulation of the nerve and muscle function, blood pressure and blood sugar levels as well as making bone, protein, and dna
electrolytes are
minerals that have an electric charge and present in all body fluids
clients at greatest risk for electrolyte imbalce are
infants children older adults clients have cognitive disorders clients who have a chronic illness
low k+ risk factors
meds:
- corticosteroids
- diruretcis
- digitalis
- abuse of laxatives
body fluid loss
- vomiting
- diarrhea
- wound drianage
- ng suction
excessive diaphoresis
kidney disease
dietary deficiency
alkalosis
low k+ clinical maifestations
- muscle weakness, cramping
- fatigue
- nausea, vomiting
- irritability, confusion
- decreased bowel motility
- dysrhthmias
nursing interventions for low k+
- monitor ecg
- assess respiraotry status
- initiate fall precautions
- monitor i&o
- anticipate monitoring lab values
- give potassium replacement as ordered (oral or iv)
- pt. education
risk factors and for high k+
renal failure
excessive potassium intake
CM for high k+
- ventricular dysrhythmias
- muscle twitching and numbness
- muscle weakness
- increased bowel motility
nursing interventions high in k+
- monitor ecg
- assess bowel sounds
- question dialysis
- dietary teaching
risk factors low sodium na+
gi loss
water intoxication
excessive diaphoresis
low sodium na+
weakness lethargy confusion seizures headahce muscle cramps, twitching hypotension tachycardia weight gain/edema
nursing interventions low na
sodium replacement (oral, gtube, iv)
restrict oral fluid intake
daily weight
monitor strcit i&oa
risk factors for high na
water deficent gi loss hypertonic tube feedings diabetes insipidus burns heatstroke
clinical manifestations for high na
fever swollen, dry tongue dry mucous membranes hallucinations seizures tachycardia hypertension hyperreflexia, twitching
high na+ nursing interventions
- daily weights
- monitor i&o
- seizure precautions
- ov infusion of hypotonic or isotonic fluid as order
- diuretics
- dietary sodium restrictions
- increase oral fluid intake
low calcium risk factors
- hypoparathryoidism
- hypomagnesium
- kidney failure
- vitamin d deficiency
low calcium disease process
celiac
lactose intolerance
chrons disease
alcohol abuse
low calcium clinical manifestations
tenancy cramps paresthesia dysrhythmias seizures hyperreflexia impaired clotting time
low calcium nursing interventions
- seizure precautions
- iv calcium replacemnt
- daily calcium supplements as ordered
- vitamin d therapy
- monitor for orthostatic hypotension
- dietary education
high calcium risk factors
- hyperparathryoidms
- maligant disease
- prolonged immoblization
- vitamin d excess
- lithium
- digoxin toxicity
- overuse of calcium supplements
high ca clinical manifestations
- muscle weakness/hyporeflexia
- kidney stones/ flank pain
- dysrthmias
- lethargy coma
- polyurina, polydipsia, dehydration
- pathological fractures/ deep bone pain
- hypertension
- nausea/vomiting
hypercalcemia nursing interventions
- increase mobility
- isotonic ivf as ordered
- diaylysis
- cardiac monitoring
hypomagnesium risk factors
gi loss alcoholism hypocalcemia hypokalemia dka malabsorption tpn laxative abuse acute mi
low mg nursing interventions
- seizure precautions
- monitor swallowing
- anticipate medications
- strict i&o
- assess respirator status
- ecg monitoring
hypermangensium risk factors
renal failure excessive mag therapy adrenal insufficiency laxative overuse lithium toxicity extensive soft tissuse injury or necrosis
high mg clinical manifestations
hypotension drowsiness bradyvardia coma cardiac arrest hyporefelxia nausea vomiting facial flushing
high mg nursing interventions
mechanical ventilation iv fluids monitor respiratory status monitor ecg blood pressure assess deep tendon reflexes
high mg nursing interventions
monitor ecg blood pressure
asssess deep tendon relfexes
