Acid Base Balance Flashcards
Goal of an ABG?
identify acidosis or alkalosis
Rule of the B’s
if pH and BICARB are BOTH in the same direction then it is METABOLIC
If pH and bicarb are in different directions…
respiratory
normal pH
7.35-7.45
normal bicarb
22-26
What do you see with low pH…
acidosis
as the pH goes, so does my patient
-low pH, low S/S
hyporeflexic, bradycardic, bradypnec, lethargy, obtunded, coma
obtunded
1 step lower than lethargic
What do you see with high pH…
alkalosis
as the pH goes, so does my patient
-high pH, high S/S
irritability, hyperreflexic, tachypnea, tachycardic
what is a hyporeflexic finding?
0, +1
what is a normoreflexic finding?
+2
what is a hyperreflexic finding?
+3, +4
paralytic ileus
down
borborygmi
up; increased bowel sounds
who would need a ambu bag at bedside?
acidosis–resp arrest, down S/S
who would need suctioning at the bedside?
alkalosis–seize, up S/S
Potassium and pH…
as goes my pH, so does my patient except potassium
-opposite
acidosis…potassium is…?
high
alkalosis…potassium is…?
low
Kussmaul breathing
MacKussmaul
-metabolic acidosis
over/under ventilate, translate…
overventilation= respiratory alkalosis
underventilation= respiratory acidosis
Example: pt is overusing breathing techniques during labor
over ventilating= respiratory alkalosis
Example: near drowing
respiratory acidosis
Example: emphysema, air trapping
respiratory acidosis
When assessing ventilation, think…
gas exchange at the lung level…not RR
Example: Your patient is on a PCA pump, what acid base imbalance would indicate backing off the pump?
respiratory acidosis
Prolonged gastric suction or vomitting?
Metabolic alkalosis
For everything that isnt lung and isnt vomitting/suctioning?
metabolic acidosis
Patient with hyperemesis who is now dehydrated?
metabolic acidosis
acute renal failure…
metabolic acidosis
If you don’t know it….
metabolic acidosis
Compensation: if the pH is normal…
fully compensated
Compensation: if the pH is out of range and only one of the others out of range….
uncompensated
Compensation: all levels out of range…
partially compensated
“partiALLy”
normal CO2
35-45
