HURST Review: Acid-Base Balance
Metabolic Acidosis: Which organ has a problem?
kidneys
Metabolic Alkalosis: Which organ has a problem?
kidneys
Respiratory Acidosis: Which organ is going to compensate?
kidneys
Respiratory Alkalosis: Which organ is going to compensate?
kidneys
Metabolic Acidosis: Too much or too little bicarb?
too little
Metabolic Alkalosis: Too much or too little hydrogen?
too little
Respiratory Alkalosis: Too little or too much CO2 in the body?
too little
Metabolic Acidosis: Too much or too little hydrogen?
too much
Metabolic Alkalosis: Too much or to little bicarb?
too much
Respiratory Acidosis: Too much or too little CO2 in the body?
too much
Metabolic Acidosis: Causes
-DKA -starvation -renal failure -severe diarrhea (lower GI, think losing base)
Metabolic Acidosis: Signs/Symptoms
-depend on the cause -hyperkalemia -increased resp. rate (Kussmaul respirations)
Metabolic Alkalosis: Signs/Symptoms
-depends on cause -observe LOC -serum potassium will go down -monitor for muscle cramps & life-threatening arrhythmias
Respiratory Acidosis: Treatment
-fix the breathing problem -with pneumonia: liquefy & mobilize secretions -with pneumothorax: chest tubes -encourage turn, cough and deep breathe (TCDB)
Metabolic Alkalosis: Treatment
-fix the problem -replace potassium
Respiratory Acidosis: Signs/Symptoms
-headache -confused -sleepy -could lead to coma -hypoxic as acid increases, LOC goes down
Respiratory Alkalosis: Causes
-hyperventilation -hysterical situation -acute aspirin overdose (stimulates the resp. system)
Respiratory Alkalosis: Signs/Symptoms
-lightheaded -faint feeling -peri-oral numbness -numbness and tingling in fingers and toes
Metabolic Alkalosis: Causes
-loss of upper GI contents; upper GI think acid, losing acid -too many antacids (too much bicarb)
Respiratory Alkalosis: Treatment
-may have to sedate client to decrease resp. rate -treat the cause -monitor ABGs
Metabolic Acidosis: Hyperkalemia manifestations
-muscle twitching -muscle weakness -flaccid paralysis -arrhythmias
Normal HCO3 (bicarb) range
22-26
Normal PaCO2 range
35-45
Normal pH range
7.35-7.45
Normal PaO2 range
80-100
Major lung chemical
CO2
Metabolic Acidosis: What chemical will the lungs compensate with?
CO2
Respiratory Acidosis: What chemical is causing the problem?
CO2
Respiratory Alkalosis: What chemical is causing the problem?
CO2
What chemical will the lungs compensate with?
CO2
Respiratory Acidosis: Hypoventilating or hyperventilating?
Hypoventilating
Metabolic Acidosis: Why does DKA and starvation cause metabolic acidosis?
The cells are starved because glucose is not available. The body will break down fat for energy. As a result of fat breakdown, ketones are produced causing acidosis.
Bicarbonate is
a base
Partially compensated means the pH is
abnormal
Hypoventilation can lead to
acidosis
Hyperventilation can lead to
alkalosis
CO2 is
an acid
Hydrogen is
an acid
Metabolic Acidosis: Which kidney chemicals are causing the problem?
bicarb & hydrogen
Metabolic Alkalosis: Which kidney chemicals are causing the problem?
bicarb & hydrogen
Kidney chemicals are
bicarb and hydrogen
Respiratory Acidosis: The kidneys are compensating with what chemicals?
bicarb and hydrogen
Respiratory Alkalosis: Kidneys are compensating with what two chemicals?
bicarb and hydrogen
The kidneys remove excess acid and ___________ by
bicarb; excreting them through the urine
What can occur if the pH is messed up
coma
Increased CO2 equals
decreased LOC and decreased O2
A person can __________ from acidosis or alkalosis making them _________ _____________ clients
die; high-priority
An alkalotic person is
excitable
Respiratory Acidosis: The body must ___________ hydrogen and ___________ bicarb
excrete; retain
Respiratory Alkalosis: The body will _________ bicarb and __________ the hydrogen
excrete; retain
Metabolic Alkalosis: pH high or low?
high
Respiratory Alkalosis: pH high or low
high
The kidneys can retain ___________ and ____________ and return to the blood
hydrogen; bicarb
Metabolic acidosis equals
hyperkalemia
Respiratory Alkalosis: Hyperventilating or hypoventilating?
hyperventilating
Metabolic alkalosis equals
hypokalemia
Metabolic Acidosis: Respiratory rate will ___________ to get rid of acid
increase
An acidotic person is
lethargic
Respiratory Alkalosis: Gaining or losing CO2?
losing
Metabolic Acidosis: pH low or high
low
Respiratory Acidosis: Is the pH high or low?
low
Metabolic Acidosis: Which organ is going to compensate?
lungs
Metabolic Alkalosis: Which organ is going to compensate?
lungs
Respiratory Acidosis: Which organ has a problem?
lungs
Respiratory Alkalosis: Which organ has a problem?
lungs
Full compensated means the pH is
normal
Early signs and symptoms of hypoxia?
restlessness and tachycardia
Respiratory Acidosis: Causes
retain CO2 -mid-abdominal incision -narcotics -sleeping pills -pneumothorax -collapsed lung -pneumonia
What responds first during a pH imbalance?
the lungs; the kidneys can take hours to days to do their job
Metabolic Acidosis: Treatment
treat the cause
Serum potassium will go ____________ in metabolic acidosis and go __________ in metabolic alkalosis.
up; down
