Acid base

Lungs compensate for metabolic disturbance by changing co2

Kidneys compensate for respiratory by changing bicarb

Metabolic alkalosis

Loss of hydrogen chloride and potassium Causes: vomiting, gastric suctioning, diuretics that promote potassium excretion, bicarb containing antacid

A client with emphysema is at a greater risk for developing what acid-base imbalance?

Chronic respiratory acidosis

What is the lab test commonly used in the assessment and treatment of acid-base balance?

Arterial blood gas

The emergency department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG?

Bicarbonate

When a client's ventilation is impaired, the body retains which substance?

Carbon dioxide (CO2)

Metabolic acidosis

Caused by gain of hydrogen ions or loss of bicarb Causes: Diarrhea, fistula, diuretic use, renal insufficiency, DKA

The physician has prescribed sodium chloride for a hospitalized 51-year-old client in metabolic alkalosis. Which nursing actions are required to manage this client?

Compare ABG findings with previous results. Maintain intake and output records. Document presenting signs and symptoms.

Upon shift report, the nurse learns the following laboratory values: pH, 7.44; PCO2, 30mmHg; and HCO3,21 mEq/L for a client with noted acid-base disturbances. Which acid-base imbalance is the client most likely experiencing?

Compensated respiratory alkalosis

You patient is in respiratory acidosis, what intervention can be done to decrease CO2?

Deep breathing and coughing

Respiratory alkalosis

Excessive blowing off of co2 Causes: hyperventilation, anxiety, hypoxemia

Which of the following would be a potential cause of respiratory acidosis?

Hypoventilation

What organ system is responsible for compensation in respiratory acidosis?

Kidneys

A 75-year-old client who complains of a "sour stomach" has been taking baking soda (sodium bicarbonate) regularly as a self-treatment. This may place the client at risk for what acid-base imbalance?

Metabolic alkalosis

A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing?

Metabolic alkalosis

Metabolic equal

PH HIGH HCO3 HIGH ALKALOSIS PH LOW HCO3 LOW ACIDOSIS

Respiratory opposite

PH HIGH PCO2 LOW ALKALOSIS PH LOW PCO2 HIGH ACIDOSIS

Normal abg

Ph- 7.35-7.45 Pco2 35-45 Po2> 80 Hco3 22-24

A client who is being treated for pneumonia reports sudden shortness of breath. An arterial blood gas (ABG) is drawn, yielding the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect?

Respiratory acidosis

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

Respiratory acidosis

Overdose of morphine will cause what imbalance?

Respiratory acidosis- decreased breaths too much co2

A client has been diagnosed with metabolic alkalosis. The nurse should anticipate what finding from the client's arterial blood gases?

Serum bicarbonate of 28 mEq/L

Carbon dioxide is a respiratory acid

Too much co2 ph goes up and you go into respiratory alkalosis

What may cause respiratory alkalosis in a patient who suffers from anxiety?

hyperventilation

The nurse is interpreting blood gases for a client with acute respiratory distress syndrome (ARDS). Which set of arterial blood gas values indicates respiratory acidosis?

pH 7.25, Pa<sc>CO2 48, HCO3 24

A client recovering from an acute asthma attack experiences respiratory alkalosis. The nurse measures a respiratory rate of 46 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 162/90 mm Hg, and a temperature of 98.6° F (37° C). To help correct respiratory alkalosis, the nurse should:

instruct the client to breathe into a paper bag.

Respiratory acidosis

low ph high co2 Inadequate secretion of co2 with inadequate ventilation Causes: Edema, aspiration of foreign object, atelectasis, sleep apnea, obesity, drug overdose and COPD

A nurse assesses arterial blood gas results for a client in acute respiratory failure (ARF). Which of the following results are consistent with this disorder?

pH 7.28, PaO2 50 mm Hg

When evaluating a client's arterial blood gases (ABGs), which value is consistent with metabolic alkalosis?

pH 7.48

Which set of arterial blood gas (ABG) results requires further investigation?

pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L

The nurse is analyzing the arterial blood gas (AGB) results of a client diagnosed with severe pneumonia. What ABG results are most consistent with this diagnosis?

pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L

Which of the following arterial blood gas (ABG) results would the nurse anticipate for a client with a 3-day history of vomiting?

pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28

A client appears flushed and has shallow respirations. The arterial blood gas report shows the following: pH, 7.24; partial pressure of arterial carbon dioxide (PaCO2), 49 mm Hg (6.5 kPa); bicarbonate (HCO3-), 24 mEq/L (24 mmol/L). These findings are indicative of which acid-base imbalance?

respiratory acidosis

A patient presents to the Emergency Department experiencing a severe anxiety attack and is hyperventilating. The nurse would expect the patient's pH value to be which of the following?

7.50

In DKA is bicarb too high or too low?

Low - ROME - metabolic issue bicarb too low

The nurse is caring for a client with multiple organ failure who is in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation?

Lungs and kidneys

A young man has developed gastric esophageal reflux disease. He is treating it with antacids. Which acid-base imbalance is he at risk for developing?

Metabolic alkalosis

The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction Which acid-base imbalance is most likely to occur?

Metabolic alkalosis

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to what acid-base imbalance?

Respiratory acidosis