Acid-Base Imbalance Flashcards
What is the normal pH range of plasma?
7.35-7.45
Normal pH is crucial for various physiological processes.
What mnemonic can help remember the direction of changes in respiratory and metabolic imbalances?
ROME
ROME stands for Respiratory is Opposite and Metabolic is Equal.
In respiratory acidosis, what is the pH level?
Less than 7.35
Indicates inadequate ventilation and CO2 retention.
What are the causes of respiratory acidosis?
- Upper airway obstruction
- Pulmonary edema
- Hypoventilation
- Head trauma
- Chest trauma
- Pneumonia
- Chronic obstructive pulmonary disease (COPD)
- Narcotic overdose
- Muscle weakness
Each cause contributes to inadequate ventilation.
What are the signs and symptoms of respiratory acidosis?
- Tachycardia
- Headache
- Decreased pulse oximetry reading
- Confusion
- Weakness
- Coma
- Hyperkalemia
- Cyanosis
- Bradypnea
- Paralysis
- Respiratory arrest
These symptoms indicate severe physiological distress.
What is the primary intervention for respiratory acidosis?
- Administer O2
- Give nebulized breathing treatments
- Treat underlying condition
- Prepare for intubation
- Provide mechanical ventilation
- Measure pulse O2
- Monitor cardiac rhythm
- Obtain intravenous access
These interventions aim to improve oxygenation and address the underlying causes.
How is acid-base imbalance determined?
- Look at the pH
- Check PaCO2 and HCO3
- Assess compensation status
Each step helps identify the type of imbalance.
In metabolic acidosis, which parameter is abnormal?
HCO3
Indicates changes in bicarbonate levels affecting pH.
What is the normal range for PaCO2?
35-45 mmHg
This is critical for assessing respiratory function.
What does an abnormal PaCO2 indicate?
Respiratory imbalance
This indicates either respiratory acidosis or alkalosis.
Fill in the blank: A pH greater than 7.45 indicates _______.
alkalosis
Alkalosis can arise from various metabolic or respiratory causes.
What supplies are needed to intubate a patient?
High-flow O2, suction, ambu bag, appropriate size endotracheal tube, 10-ml syringe, stylet, appropriate blades (Miller/Macintosh) with working handle, CO2 detector, tape or endotracheal tube securing device, and stethoscope to check placement.
What is the pH level in respiratory alkalosis?
Greater than 7.45.
What happens when a person hyperventilates in terms of CO2?
He or she expels all of his or her CO2.
What are the causes of respiratory alkalosis?
- Hyperventilation * Pain * Anxiety * Pulmonary embolus * Hypoxia * High altitude * Drug toxicity (early salicylate overdose) * Third-trimester pregnancy * Fever.
What are the signs and symptoms of respiratory alkalosis?
- Tetany or seizures from hypocalcemia * Diaphoresis * Tingling of extremities * Dizziness * Altered mental status * Anxiety * Dyspnea * Paresthesias * Palpitations * Tachycardia * Hyperventilation.
What interventions are recommended for respiratory alkalosis?
- Encourage slow deep breathing * Correct underlying condition * Provide fluids intravenously * Correct hyperventilation with nonrebreather mask without O2.
What is the pH level in metabolic acidosis?
Less than 7.35.
What causes metabolic acidosis?
- Diabetic ketoacidosis * Renal disease * Starvation * Shock or sepsis * Loss of bicarbonate in severe diarrhea.
What are the signs and symptoms of metabolic acidosis?
- Altered mental state * Hypotension * Abdominal pain * Nausea * Vomiting * Diarrhea * Kussmaul respirations * Hyperventilation * Tingling and numbness * Hyperkalemia * Peaked T waves * Flushed, warm skin * Headache * Bradycardia * Muscle weakness.
What interventions are recommended for metabolic acidosis?
- Provide fluids intravenously (lactated ringer’s) * Treatment may include intravenous sodium bicarbonate, intravenous dextrose, and intravenous regular insulin * Assist ventilations * Monitor cardiac rhythm * Perform basic metabolic panel (BMP).
What is the pH level in metabolic alkalosis?
Greater than 7.45.
What causes metabolic alkalosis?
- Loss of stomach acid (vomiting) * Ingesting too many alkali substances (antacids, milk of magnesia, baking soda) * Diuretics * Hypokalemia * Cushing’s syndrome.
What are the signs and symptoms of metabolic alkalosis?
- Hypocalcemia (tetany, twitching, irritability, shaking, seizures) * Confusion * Nausea * Vomiting * Diarrhea * Coma * Decreased ST segment * Bradypnea * Hypokalemia (muscle weakness, loss of reflexes) * Polyuria.
