Acid Base imbalance Flashcards
ph
7.35-7.45
paO2
80-100 mm Hg
paCO2
35-45 mm Hg
HCO3
22-26 mEq/L
6 causes of respiratory acidosis
- hypoventilation
- drug overdose
- pulmonary edema
- chest trauma/ neuromuscular disease
- COPD
- airway obstruction
- respiratory depression (anesthesia, increase ICP)
- decrease alveolar capillary diffusion ( pneumonia, ARDS, PE, COPD)
6 causes of metabolic acidosis
- diabetic ketoacidosis
- salicylate OD
- renal failure
- severe diarrhea
- sepsis
- shock
6 causes of respiratory alkalosis
- hyperventilation
- initial stages of pulmonary emboli
- hypoxia
- fever
- pregnancy
- anxiety
3 causes of metabolic alkalosis
- overuse of antacids
- potassium wasting diuretics
- loss of gastric juices
- severe vomiting
- GI suctioning
- excessive NaHCO3
- diuretics
signs and symptoms of metabolic acidosis
- headache
- decreased BP
- hyperkalemia
- muscle twitching
- warm, flushed skin (vasodilation)
- nausea, vomiting, diarrhea
- Changes on LOC ( confusion, increase drowsiness)
- kussmaul respirations ( compensatory hyperventilation)
potassium levels in acidosis
K+ goes up in acidosis
nursing management of metabolic acidosis
- renal function ( check BUN, creatinine,hemaglobin, hemocrit
- monitor hydration status for problems with with fluid balance
- respiratory function- turn, cough and deep breathe
- Check ABG’s and assess for Kussmaul respirations
- check electrolyte levels K+ goes up and Ca+ usually goes down
- assess for cardiac dysrhythmias
- assess blood sugar levels
- antidiarrheal medications and soda bicarb that may be given to correct acidosis
what is hyperkalemia frequently associated with?
Metabolic acidosis
signs and symptoms of metabolic alkalosis
- restlessness followed by lethargy
- dysrhythmias (tachycardia)
- compensatory hypoventilation
- confusion ( decrease LOC, dizzy, irritable)
- nausea, vomiting, diarrhea
- tremors, muscle cramps, tingling of fingers and toes
- hypokalemia
nursing management of metabolic alkalosis
- ABGs for ph
- serum K+ and Ca++ levels
- check cardiac status
- check IV orders and monitor ECGs for dysrhythmias and tachycardia
- neurological checks for tetany, tremors, muscle cramps, and tingling fingers and toes
signs and symptoms of respiratory acidosis
- hypoventilation –> hypoxia
- rapid, shallow, respirations
- decreased BP
- skin/ mucosa pale to cyanotic
- headache
- hyperkalemia
- dysrhythmias ( increase K+)
- drownsiness, dizziness, disorientation
- muscle weakness, hyperreflexia
nursing management of respiratory acidosis
- ventilator
- ABGs
- low-dose oxygen in chronic condition
- high-dose oxygen in acute hypoxia with acidosis
- I & O
- vital signs, hydrated, watch the ECG bc increase K+ can cause dysrhythmias
- promote the release of CO2
- turn, cough and breathe deeply
- assume the semi-flower position
- clear respiratory secretions
Signs and symptoms of respiratory alkalosis
- seizures
- deep, rapid, breathing
- hyperventilation
- tachycardia
- decreased or normal BP
- hypokalemia
- numbness and tingling of extremities
- lethargy and confusion
- light headedness
- nausea, vomiting
nursing management of respiratory alkalosis
treatment: paper bag
MONITOR
1. respiratory rate and depth
2. tachycardia or decreased BP
3. Serum K+ levels– cardiac dysrhythmias
4. hydration status–I & O
5. if the client is on digitalis then check for toxicity
severe diarrhea
metabolic acidosis
anxiety
respiratory alkalosis
DKA
metabolic acidosis
Cocaine overdose
respiratory alkalosis
severe vomiting
metabolic alkalosis
pulmonary embolism
respiratory alkalosis
