Acid-Base Imbalances

Question 1

Metabolic Acidosis is a clinical disturbance characterized by what?

Answer 1

Low pH and a low plasma bicarb concentration

Question 2

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

Answer 2

It will decrease severely

Question 3

Causes of Metabolic Acidosis (ACIDOTIC)

Answer 3

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

Question 4

What system tries to compensate during Metabolic Acidosis?

Answer 4

Respiratory

Question 5

What is the blood pH with Acidosis?

Answer 5

Less than 7.35

Question 6

S/S of Metabolic Acidosis

Answer 6

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

Question 7

What to watch for w/ Metabolic Acidosis

Answer 7

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

Question 8

Normal pH level

Answer 8

7.35-7.45

Question 9

Normal pCO2 level

Answer 9

35-45

Question 10

Normal pO2 level

Answer 10

80-100

Question 11

Normal HCO3 level

Answer 11

22-26

Question 12

What is CO2?

Answer 12

An ACID

Question 13

Steps for reading ABG’s

Answer 13

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

Question 14

Respiratory Acidosis LABS

Answer 14

• decreased pH
• normal bicarb
• increased PCO2

Question 15

Respiratory Alkalosis LABS

Answer 15

• increased pH
• normal bicarb
• decreased PCO2

Question 16

Metabolic Acidosis

Answer 16

• decreased pH
• decreased bicarb
• decreased PCO2

Question 17

Metabolic Alkalosis LABS

Answer 17

• increased pH
• increased bicarb
• increased PCO2

Question 18

What does the compensatory mechanism for Respiratory Acidosis do?

Answer 18

excess hydrogen is excreted in the urine and bicarb is retained

Question 19

What does the compensatory mechanism for Respiratory Alkalosis do?

Answer 19

renal excretion of bicarb increases and hydrogen ions are retained

Question 20

What does the compensatory mechanism for Metabolic Acidosis do?

Answer 20

increase the ventilation rate

Question 21

How does the body compensate during Metabolic Alkalosis?

Answer 21

hypoventilates to conserve CO2 and increases the pCO2

Question 22

What does both arrows going in same direction mean?

Answer 22

the body is compensating!

Question 23

Respiratory Acidosis is due to what?

Answer 23

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

Question 24

Most common cause of Respiratory Acidosis is what?

Answer 24

bradypnea/hypoventilation

Question 25

Causes of Respiratory Acidosis (DEPRESS)

Answer 25

``` 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 ```

Question 26

S/S of Respiratory Acidosis

Answer 26

- neuro decline - headache/full in head/mentally cloudy - tachypnea - low BP - increased ICP - vfib

Question 27

What to do for patient in Respiratory Acidosis

Answer 27

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

Question 28

Metabolic Alkalosis

Answer 28

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

Question 29

Causes of Metabolic Alkalosis (ALKALI)

Answer 29

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

Question 30

Aldosterone production causes you lose what?

Answer 30

Potassium and hydrogen ions

Question 31

S/S of Metabolic Alkalosis

Answer 31

- bradypnea/hypoventilation - symptoms of hypokalemia - tetany,tremors - muscle weakness - cardiac probs - respiratory depression

Question 32

Respiratory Alkalosis is ALWAYS caused by what?

Answer 32

Hyperventilation

Question 33

S/S of Respiratory Alkalosis

Answer 33

- increased HR/RR - light headed - decreased concentration - tingling in extremities

Question 34

Causes of Respiratory Alkalosis (TACHYPNEA)

Answer 34

``` 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 ```