Saunders Acid-base
normal potassium levels
3.5-5.0 mEq/L
normal pH
7.35-7.45
respiratory acidosis
A drop in blood pH due to hypoventilation (too little breathing) and a resulting accumulation of Co2.
medication for metabolic alkalosis
Acetazolamide is a diuretic used in the treatment of metabolic alkalosis. This medication causes excretion of sodium, potassium, bicarbonate, and water by inhibiting the action of carbonic anhydrase.
signs and symptoms of metabolic alkalosis
exhibit a decrease in respiratory rate and depth, nausea, vomiting diarrhea, restlessness, numbness and tingling in the extremities twitching in the extremities, hypokalemia, hypocalcemia, dysrhythmias.
metabolic alkalosis
high pH, high HCO3
respiratory alkalosis
Arise in blood pH due to hyperventilation (excessive breathing) and a resulting decrease in CO2.
Labs for respiratory alkalosis
Arterial blood gas: pH levels Pco2 Levels potassium Levels
causes for metabolic alkalosis
Cause: ingestion of antiacids Prolonged Vomiting - (loss of Na, K, H, and Cl) Gastrointestinal Suctioning Increased Bicarb Intake / Administration Excessive Adrenal Corticoid hormone /Hyperaldosteronism Diuretic Therapy Hypokalemia Excessive Baking Soda Ingestion
metabolic acidosis for pt with server diarrhea
intestinal secretion high in bicarbonate may be lost through enteric drainage tubes, an ileostomy or diarrhea
respiratory alkalosis Pco2 value
less than 35
pH levels
Normal = 7.35 Acidosis = below 7.35 Alkalosis = above 7.35 Pco2 levels are opposite of the ph levels
Kussmaul's respirations
abnormally deep regular and rapid respiration observed in the pt with diabetic ketoacidosis.
resperatory acidosis Pco2 value
above 45
Which clients would the nurse determine is at risk for development of metabolic alkalosis?
client who has been vomiting for 2 days
metabolic acidosis causes
Primary Cause: Addition of large amounts of fixed acids to body fluids; Contributing Causes: Lactic acidosis (circulatory failure), Ketoacidosis (diabetes, starvation), Phosphates and sulfates (Renal dz), Acid ingestion (salicylates), Secondary to respiratory alkalosis, Adrenal insufficiency
high risk patients for respiratory acidosis
clients with: asthma pneumonia server anxiety due to increase in acids in the body that affect the respiratory system
High pH and low Pco2 levels
Respiratory alkalosis
high risk patients for metabolic acidosis
clients with: diabetes kidney failure malnourishment pancreatitis status epilepticus prolonged diarrhea due to increase in acids in the body
A client presents to the emergency department with lethargy; deep, regular respirations; and a fruity odor to the breath. The client's arterial blood gas (ABG) results are pH of 7.25, Pco2 of 34 mm Hg, Po2 of 86 mm Hg, and HCO3- of 14 mEq/L. The nurse interprets that the client has which acid-base disturbance?
metabolic acidosis
A client underwent creation of an ileostomy 2 days ago. The nurse checks the client for signs of which acid-base disorder that a client with an ileostomy is at risk for developing?
metabolic acidosis
The nurse is assisting in the care of a client who had an ileostomy created a few days ago. The client has high output of drainage from the ileostomy. Based on this the nurse monitors the client for which acid-base imbalance?
metabolic acidosis
The nurse is collecting data from a client with a suspected diagnosis of gastric ulcer. The client tells the nurse that oral antacids are taken frequently throughout the day. The nurse continues to collect data from the client, understanding that the client is at risk for which acid-base disturbance?
metabolic alkalosis
Which arterial blood gas (ABG) result should the nurse anticipate in the client who develops metabolic alkalosis after profuse vomiting for 2 days?
pH 7.49; Pco2 45; HCO3- 30
Normal Arterial Blood Gas Values
pH- 7.35-7.45 PcO2- 80-100 PaCO2- 35-45 HCO3- 21-28
apnea (respiratory)
respirations cease for several seconds
cheyne-strokes resp
respirations gradually become more shallow and are followed by periods of apnea (no breathing) with repetition of the pattern
bradypnea
respirations that are regular in rhythm but slower than normal in rate
Defects in the function of the lungs or changes in normal respiratory patterns from secondary problems
respiratory acidosis
pts with COPD has what acid-base imbalance
respiratory acidosis
Signs and symptoms of respiratory alkalosis
tachypnea, change in mental status, dizziness, pallor around the mouth, spasms of the muscles of the hands, and hypokalemia.
Guillain-Barre Syndrome (GBS)
temporary paralysis caused by an autoimmune attack on peripheral myelin, causing weakness and usually ascending paralysis of the limbs, face and diaphragm retain CO2= respiratory acidosis
metabolic alkalosis for a pt with an NG tube
the loss of fluid or vomiting causes metabolic condition due to loss of hydrochloric acid
Decrease in bicarbonate levels
creates the actual base deficit of metabolic acidosis
metabolic acidosis
decreased pH in blood and body tissues as a result of an upset in metabolism
persistent vomiting risks
dehydration metabolic alkalosis
A client has had a set of arterial blood gases drawn. The results are pH, 7.34; Paco2, 37 mm Hg; Pao2, 79 mm Hg; and HCO3,- 19 mEq/L. The nurse interprets that the client is experiencing which acid-base imbalance?
metabolic acidosis
The nurse reviews the arterial blood gas results of a client and notes that the results indicate a pH of 7.30, Pco2 of 52 mm Hg, and HCO3- of 22 mEq/L. Which interpretation should the nurse correctly make about these results?
respiratory acidosis
Arterial blood gases (ABGs) are obtained on a client with pneumonia. The ABG results are pH, 7.50; Pco2, 30 mm Hg; HCO3-, 20 mEq/L; and Po2, 75 mm Hg. The nurse interprets these results and determines that which acid-base condition exists?
respiratory alkalosis
The nurse is caring for a client who is nervous and is hyperventilating. The nurse should monitor the client for signs of which acid-base imbalance?
respiratory alkalosis
The nurse is told that the arterial blood gas (ABG) results indicate a pH of 7.50 and a Pco2 of 32 mm Hg (32 mm Hg). The nurse determines that these results are indicative of which acid-base disturbance?
respiratory alkalosis
best way to treat an acid-base disorder
to treat the underlying disorder first to stop the primary cause of the acid-base imbalance
hyperkalemia: lab findings
◯ Serum potassium Increased - Greater than 5 mEq/L ◯ Arterial blood gases Metabolic acidosis - pH less than 7.35
The nurse is caring for a client with severe diarrhea. The nurse monitors the client closely, understanding that this client is at risk for developing which acid-base disorder?
metabolic acidosis
