Acid/Base Balance

  1. Normal PaO2 value
    80-100 mmHg
  2. Normal PaCO2

    *Remember, pH is 7.35-7.45.
  3. Normal HCO3
    22-26 mEq/L
  4. What can cause respiratory acidosis?
    Occurs when you retain too much CO2, so decreased respiration's.

    Ex: Mid abdominal incision, pneumothorax (it hurts to breath)
  5. If you see restlessness, what should you think first?
  6. what are the early signs of hypoxia?
    Restlessness and tachycardia
  7. S/S of respiratory acidosis
    HA, confusion, sleepy, could lead to coma
  8. How will you fix respiratory acidosis
    Fix breathing problem: treat pneumonia, get rid of secretions, deep breathing, etc.
  9. What can cause respiratory alkalosis?
    • Hyperventilation! Client is breathing too fast and removing CO2
    • Client may be hysterical
    • *Acute aspirin overdose can also cause it as aspirin stimulates the respiratory center
  10. S/S of respiratory alkalosis
    • Acute respiratory alkalosis causes vasoconstriction of cerebral vessels, resulting in lightheadedness and fainting. 
    • Peri-oral numbness (around lips)
    • also numbness and tingling in fingers and toes
  11. Treatment for respiratory alkalosis
    • Don't wait for kidneys to kick in, this takes days
    • Breath in paper bag
    • May need to sedate pt
    • Treat cause and monitor ABG's
  12. What's the deal with metabolic acidosis?
    • Kidneys are sick, retaining hydrogen and not enough bicarb
    • Respiratory rate will go up to blow off CO2 (acid) to try to level out pH
  13. Causes of metabolic acidosis
    • DKA
    • Starvation
    • Renal failure - duh
    • Severe diarrhea
  14. What's the deal with DKA and starvation causing metabolic acidosis?
    • Cells are starving for glucose so body breaks down protein and fats.  
    • When fats break down, results in ketones
    • Ketones are acid
  15. When a DM pt becomes acidic, like with DKA, what are their respirations doing?
    • Respiration's go up to blow off acid. 
    • Called Kussmauls respiration's.
  16. How does diarrhea cause metabolic acidosis?
    • Intestines have alot of bicarb in them. 
    • Severe diarrhea will cause excessive loss of bicarb
  17. S/S of metabolic acidosis
    Depends on cause (DKA = RR ↑ , s/s of malnutrition)

  18. Treatment of metabolic acidosis
    Treat the prob
  19. What drug may fix metabolic acidosis?
    • IV sodium bicarb
    • May not fix the prob, but will buy time to figure out the cause
  20. What happens with potassium in metabolic acidosis?
    Goes up!!
  21. What can cause metabolic alkalosis
    *Prob is they are retaining too much bicarb

    • Loss of upper GI contents, such as from vomiting or NG tube hooked to suction
    • Too many antacids which = too much base
    • Too much IV bicarb
  22. S/S of metabolic alkalosis
    • Depends on cause
    • Observe LOC
    • Monitor for muscle cramps and life threatening arrhythmias
  23. What happens with potassium in metabolic alkalosis
    It goes down!!
  24. How do you know that compensation is occuring?
    BOTH bicarb and CO2 will be abnormal.
  25. What happens if there is partial compensation?
    pH will be Abnormal!
  26. What happens with full compensation
    pH will be normal
Card Set
Acid/Base Balance
Acid Base