Metabolic Acidosis/Alkalosis

Metabolic Acidosis?

a condition characterized by a deficiency of bicarbonate ions in the body in relation to the amount of carbonic acid in the body, in which the pH falls to less than 7.35

Metabolic Alkalosis?

a condition characterized by an excess of bicarbonate ions in the body in relation to the amount of carbonic acid in the body; the pH rises to greater than 7.45

Causes of Metabolic Acidosis?

- Diabetic Ketoacidosis - Lactic acidosis - Starvation - Severe diarrhea - renal failure - GI fistulas - shock

CV S&S of Metabolic Alkalosis?

-Tachycardia -Dysrhythmias (related to hypokalemia from compensation)

Neruomuscular S&S of Metabolic Alkalosis?

-Tetany -Tremors -Tingling of finger and toes -Muscle cramps, hypertonic muscle -Seizures

Treatment for Metabolic Acidosis?

-treat underlying cause -Resp. support (mechanical ventilation) -Give NaHCO3

Nursing intervention for Metabolic Alkalosis?

-Assess I&O -LOC -HR & rhythm -VS -Assess neuro status -ABG's

CV S&S of Metabolic Acidosis?

-Decrease BP -Dysrhythmias (related to hyperkalemia from compensation) -Warm, flushed skin (peripheral vasodilation)

Resp. S&S of Metabolic Acidosis?

-Deep, rapid respiration (compensation by the lungs)

Neuro S&S of Metabolic Alkalosis?

-Dizziness -Irritability -Nervousness, confusion

Neuro Sign & Symptoms of Metabolic Acidosis?

-Drowsiness -Confusion -HA -Coma

Pathophysiology of Metabolic Acidosis?

-Gain of fixed acid ,inability to excrete acid, or loss of base. -Compensatory response of CO2 excretion by the lungs (Resp. Alkalosis) increase RR

Resp. S&S of Metabolic Alkalosis?

-Hypoventilation (compensatory action by the lungs)

Pathophysiology of Metabolic Alkalosis?

-Loss of strong acid or gain of base -Compensatory response of CO2 retention by the lungs (Resp. Acidosis) decreased RR

Nursing interventions for Metabolic Acidosis?

-Monitor VS -Neuro status -ABG's -K+ levels (elevated) -Make sure client has large-bore IV -Orient pt as needed -O2 as needed -position client to promote chest expansion

GI S&S of Metabolic Alkalosis?

-N/V -Anorexia

GI S&S of Metabolic Acidosis?

-N/V/D, abdominal pain

Lab findings of Metabolic Acidosis?

-Plasma pH increase -PaCO2 normal (uncompensated) -PaCO2 decrease (compensated) -HCO3 decrease -Urine pH <6 (compensated)

Lab findings of Metabolic Alkalosis?

-Plasma pH increase -PaCO2 normal (uncompensated) -PaCO2 increase (compensated) -HCO3 increase -Urine pH >6 (compensated)

Treatment for Metabolic Alkalosis?

-correct underlying cause -discontinuation of thiazide diuretics -antiemetics -acetazolamide

Causes of Metabolic Alkalosis?

-excessive vomiting -prolonged gastric suctioning -electrolyte disturbances (hypokalemia) -Cushing's disease -excessive NaHCO3 intake -OD on baking soda -diuretics -excessive mineralocorticoids.