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Critical Care Nursing > Acid-Base Imbalances > Flashcards

Acid-Base Imbalances Flashcards

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1
Q

Metabolic Acidosis is a clinical disturbance characterized by what?

A

Low pH and a low plasma bicarb concentration

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2
Q

Any time the body has too much acid what happens to the bicarb?

A

It will decrease severely

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3
Q

Causes of Metabolic Acidosis (ACIDOTIC)

A 
Body produces too much acid or loses too little base
A-aspirin toxicity/alcoholism
C-carbohydrates not metabolized (lactic acid)
I-insufficiency of kidneys 
D-diarrhea/DKA
O-ostomy drainage 
T-fisTula 
I-intake of high fat diet 
C-chronic starvation
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4
Q

What system tries to compensate during Metabolic Acidosis?

A

Respiratory

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5
Q

What is the blood pH with Acidosis?

A

Less than 7.35

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6
Q

S/S of Metabolic Acidosis

A
  • kussmaul breathing/rapid breathing-hyperventilate
  • weak
  • peripheral vasodilation
  • confused
  • low BP
  • n/v
  • cardiac changes
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7
Q

What to watch for w/ Metabolic Acidosis

A
  • watch for respiratory distress/mechanical ventilation
  • watch for hyperkalemia/calcium
  • neuro status/seizure precautions
  • strict I/O’s
  • dialysis/
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8
Q

Normal pH level

A

7.35-7.45

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9
Q

Normal pCO2 level

A

35-45

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10
Q

Normal pO2 level

A

80-100

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11
Q

Normal HCO3 level

A

22-26

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12
Q

What is CO2?

A

An ACID

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13
Q

Steps for reading ABG’s

A
  • look at pH (normal/abnormal)
  • look at pCO2
  • look at bicarb
  • is there compensation?
  • what type of compensation? (full/partial)
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14
Q

Respiratory Acidosis LABS

A
  • decreased pH
  • normal bicarb
  • increased PCO2
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15
Q

Respiratory Alkalosis LABS

A
  • increased pH
  • normal bicarb
  • decreased PCO2
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16
Q

Metabolic Acidosis

A
  • decreased pH
  • decreased bicarb
  • decreased PCO2
17
Q

Metabolic Alkalosis LABS

A
  • increased pH
  • increased bicarb
  • increased PCO2
18
Q

What does the compensatory mechanism for Respiratory Acidosis do?

A

excess hydrogen is excreted in the urine and bicarb is retained

19
Q

What does the compensatory mechanism for Respiratory Alkalosis do?

A

renal excretion of bicarb increases and hydrogen ions are retained

20
Q

What does the compensatory mechanism for Metabolic Acidosis do?

A

increase the ventilation rate

21
Q

How does the body compensate during Metabolic Alkalosis?

A

hypoventilates to conserve CO2 and increases the pCO2

22
Q

What does both arrows going in same direction mean?

A

the body is compensating!

23
Q

Respiratory Acidosis is due to what?

A

inadequate excretion of CO2 w/ inadequate ventilation resulting in elevated plasma CO2 and increased levels of carbonic acid

24
Q

Most common cause of Respiratory Acidosis is what?

A

bradypnea/hypoventilation

25
Q

Causes of Respiratory Acidosis (DEPRESS)

A 
D-drugs/diagnosed neuro dx
E-edema
P-pneumonia
R-respiratory cancer or brain damage 
E-emboli
S-spasms of bronchial tubes
S-sac elasticity of alveoli damaged
26
Q

S/S of Respiratory Acidosis

A
  • neuro decline
  • headache/full in head/mentally cloudy
  • tachypnea
  • low BP
  • increased ICP
  • vfib
27
Q

What to do for patient in Respiratory Acidosis

A
  • give oxygen
  • encourage coughing/deep breathing
  • hold meds that may cause respiratory depression
  • watch potassium
  • monitor EKG changes
  • mechanical ventilation/intubation
  • Narcan med
28
Q

Metabolic Alkalosis

A

the body has experienced an excessive loss of acids or an increased amount of bicarb

29
Q

Causes of Metabolic Alkalosis (ALKALI)

A

A-aldosterone production
L-loop diuretics
K-alkali-ingestion (baking soda/antacids/milk)
A-anticoagulant (citrate)/blood transfusions
L-loss of fluids:vomiting/diarrhea/NG suction
I-increased sodium bicarb

30
Q

Aldosterone production causes you lose what?

A

Potassium and hydrogen ions

31
Q

S/S of Metabolic Alkalosis

A
  • bradypnea/hypoventilation
  • symptoms of hypokalemia
  • tetany,tremors
  • muscle weakness
  • cardiac probs
  • respiratory depression
32
Q

Respiratory Alkalosis is ALWAYS caused by what?

A

Hyperventilation

33
Q

S/S of Respiratory Alkalosis

A
  • increased HR/RR
  • light headed
  • decreased concentration
  • tingling in extremities
34
Q

Causes of Respiratory Alkalosis (TACHYPNEA)

A 
T-temperature increase
A-aspirin toxicity 
C-controlled mechanical ventilation
H-hyperventilation 
Y-hYsteria (anxiety)
P-pain/pregnancy
N-neuro injuries
E-embolism/edema
A-asthma

Critical Care Nursing (14 decks)

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