View
151
Download
0
Category
Preview:
Citation preview
Michelle Jocson, MSN/Ed., RN
Identification of the specific acid-base imbalance is important in identifying the underlying cause of the disorder and in determining appropriate treatment
Regulate the bicarbonate level in the ECF
In respiratory acidosis and most metabolic acidosis, kidneys excrete hydrogen and conserve bicarbonate to help restore balance
In respiratory and metabolic alkalosis, kidneys retain hydrogren and
excrete bicarb
Adjusts ventilation in response to the amount of CO2 in the blood
In metabolic acidosis, respirations increase, causing greater elimination of CO2
In metabolic alkalosis, respiratory rate decreases, causing CO2 to be retained
pH 7.35-7.45 PaCO2 35-45 HCO3 22-26
Clinical disturbance characterized by low pH, and low bicarbonate (HCO3) concentration
Low pH Low HCO3
Results from direct loss of bicarbonate- Diarrhea- Diuretics- Early renal insufficiency- TPN without bicarbonate
Headache Confusion Drowsiness Increased respiratory rate and depth Nausea and vomiting Increased BP Cold, clammy skin
Clinical disturbance characterized by a high pH and a high bicarbonate
high pH high HCO3
Vomiting or gastric suction Pyloric stenosis Hypokalemia Hyperaldosteronism Cushing’s syndrome Causes decreased Calcium
Related to hypocalcemia- Tingling of the fingers and toes- Dizziness- Hypertonic muscles- Depressed respirations- Atrial tachycardia
Clinical disorder in which the pH is less than 7.35 and the PaCO2 is greater than 42 mmHg
Always due to the inadequate excretion of CO2 with inadequate ventilation, resulting in elevated CO2 levels
low pH high PaCO2
Pulmonary edema Aspiration of a foreign object Atelectasis Pneumothorax Sedative overdose Sleep apnea Severe pneumonia
Increased pulse and respiratory rate Increased BP Mental cloudiness Feeling of fullness in the head Cerebrovascular vasodilation
Arterial pH is greater than 7.45 and the PaCO2 is less than 38 mm Hg
high pH low PaCO2
Always due to hyperventilation Excessive “blowing off” of CO2- Extreme anxiety- Hypoxemia- Gram negative bacteremia- Inappropriate ventilator settings
Lightheadedness Inability to concentrate Tinnitus Loss of consciousness Tachycardia Ventricular/atrial dysrhythmias
Recommended