Acid-Base Imbalances Flashcards
Metabolic Acidosis is a clinical disturbance characterized by what?
Low pH and a low plasma bicarb concentration
Any time the body has too much acid what happens to the bicarb?
It will decrease severely
Causes of Metabolic Acidosis (ACIDOTIC)
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
What system tries to compensate during Metabolic Acidosis?
Respiratory
What is the blood pH with Acidosis?
Less than 7.35
S/S of Metabolic Acidosis
- kussmaul breathing/rapid breathing-hyperventilate
- weak
- peripheral vasodilation
- confused
- low BP
- n/v
- cardiac changes
What to watch for w/ Metabolic Acidosis
- watch for respiratory distress/mechanical ventilation
- watch for hyperkalemia/calcium
- neuro status/seizure precautions
- strict I/O’s
- dialysis/
Normal pH level
7.35-7.45
Normal pCO2 level
35-45
Normal pO2 level
80-100
Normal HCO3 level
22-26
What is CO2?
An ACID
Steps for reading ABG’s
- look at pH (normal/abnormal)
- look at pCO2
- look at bicarb
- is there compensation?
- what type of compensation? (full/partial)
Respiratory Acidosis LABS
- decreased pH
- normal bicarb
- increased PCO2
Respiratory Alkalosis LABS
- increased pH
- normal bicarb
- decreased PCO2
Metabolic Acidosis
- decreased pH
- decreased bicarb
- decreased PCO2
Metabolic Alkalosis LABS
- increased pH
- increased bicarb
- increased PCO2
What does the compensatory mechanism for Respiratory Acidosis do?
excess hydrogen is excreted in the urine and bicarb is retained
What does the compensatory mechanism for Respiratory Alkalosis do?
renal excretion of bicarb increases and hydrogen ions are retained
What does the compensatory mechanism for Metabolic Acidosis do?
increase the ventilation rate
How does the body compensate during Metabolic Alkalosis?
hypoventilates to conserve CO2 and increases the pCO2
What does both arrows going in same direction mean?
the body is compensating!
Respiratory Acidosis is due to what?
inadequate excretion of CO2 w/ inadequate ventilation resulting in elevated plasma CO2 and increased levels of carbonic acid
Most common cause of Respiratory Acidosis is what?
bradypnea/hypoventilation
Causes of Respiratory Acidosis (DEPRESS)
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
S/S of Respiratory Acidosis
- neuro decline
- headache/full in head/mentally cloudy
- tachypnea
- low BP
- increased ICP
- vfib
What to do for patient in Respiratory Acidosis
- give oxygen
- encourage coughing/deep breathing
- hold meds that may cause respiratory depression
- watch potassium
- monitor EKG changes
- mechanical ventilation/intubation
- Narcan med
Metabolic Alkalosis
the body has experienced an excessive loss of acids or an increased amount of bicarb
Causes of Metabolic Alkalosis (ALKALI)
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
Aldosterone production causes you lose what?
Potassium and hydrogen ions
S/S of Metabolic Alkalosis
- bradypnea/hypoventilation
- symptoms of hypokalemia
- tetany,tremors
- muscle weakness
- cardiac probs
- respiratory depression
Respiratory Alkalosis is ALWAYS caused by what?
Hyperventilation
S/S of Respiratory Alkalosis
- increased HR/RR
- light headed
- decreased concentration
- tingling in extremities
Causes of Respiratory Alkalosis (TACHYPNEA)
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
