acid/base imbalances Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

how to determine type of acid/base imbalance

A

determine whether HCO3 goes in the same or opposite direction with pH
• Rule of the Bs: If pH and Bicarb move both in the same direction, then the acid-base imbalance is metabolic … Otherwise, it is respiratory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  • pH 7.3

* HCO3 20

A

metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  • pH 7.58

* HCO3 32

A

metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  • pH 7.22

* HCO3 35

A

respiratory acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

As the pH goes, so goes my patient, except for….

A

Potassium … That means
• If pH is low, everything is low, except potassium
• If pH is high, everything is high, except potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If pH goes over 7.45, this is…

and everything goes (up or down?)

A

Alkalosis
• Therefore everything is up: tachycardia, tachypnea, HTN, seizures, irritability, spastic, diarrhea, borborygmi (increase bowel sounds), hyperreflexia (3+, 4+)
• However, potassium is opposite. Therefore, hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

• What is the nursing intervention for pH >7.45?

A

o Pt need suctioning because of seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If pH goes below 7.35, this is…

and everything goes (up or down?)

A

Acidosis
• Therefore, everything is down: bradycardia, constipation, absent bowel sounds, flaccid, obtunded, lethargy, coma hyporeflexia (0, 1+), bradypnea, low BP
• However, potassium is high (hyperkalemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nursing intervention for pH <7.35?

A

o Pt needs to be ventilated with an Ambu bag—respiratory arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

So, remember that “MAC Kussmaul” is the only acid-base imbalance to cause…

A

Metabolic ACidosis with Kussmaul respirations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cause of respiratory..

A

“Is it LUNG? … If yes, then it is respiratory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If UNDERventilating

A

Then pick acidosis—pH is under 7.35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If OVERventilating

A

Then it is alkalosis, pH is over 7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of acid-base derangement is present in labor?

A

o Respiratory alkalosis … Overventilating—pH increases … Alkalosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of acid-base derangement is present in drowning?

A

o Respiratory acidosis … Underventilating—pH decreases … Acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of acid-base derangement is present when pt is on PCA (patient-controlled anesthesia) pump?

A

o Ventilation is down … Respiratory acidosis

17
Q

cause of metabolic..

A

If it is not LUNG, then it is metabolic. If the patient has prolonged gastric vomiting or suction (sucking out acid), pick alkalosis
• For everything else that isn’t lung, pick metabolic acidosis