Acid-Base/ABG Interpretation pt 2

What is metabolic alkalosis?

A condition in which blood becomes too alkaline due to excessive bicarbonate or loss of acid.

What are the ABG findings for metabolic alkalosis?

pH above 7.45 and HCO₃ above 26 mEq/L.

What are the expected neurological findings of metabolic

alkalosis?

Confusion, delirium, numbness or tingling in the hands, feet, or face, and seizures.

What muscle symptoms may occur with metabolic alkalosis?

Muscle cramps and twitching.

What other symptoms may occur with metabolic alkalosis?

Nausea, vomiting, diarrhea, pain, hypotension, fatigue, and weakness.

How does alkalosis affect the nervous system?

It can cause hyperexcitability of the nervous system.

How can alkalosis affect the heart?

It can cause changes in heart contractility.

What electrolyte imbalances are associated with metabolic alkalosis?

Decreased potassium and chloride.

How can alkalosis affect bones?

Calcium release from bones may contribute to osteoporosis or fractures.

What can alkalosis do to the body's use of glucose?

It can cause changes in the body's ability to use glucose for energy.

What are the main treatments for metabolic alkalosis?

Treat the underlying cause, replace fluids and electrolytes, correct hypokalemia, and stop contributing treatments when indicated.

What should be done if vomiting is causing metabolic alkalosis?

Treat the cause of vomiting.

What treatments may need to be stopped if they contribute to metabolic alkalosis?

GI suctioning, diuretic administration, or bicarbonate administration, when indicated.

Why must hypokalemia be corrected in metabolic alkalosis?

Low potassium contributes to the acid-base imbalance and should be corrected promptly.

What medication is listed to correct low potassium in metabolic alkalosis?

Potassium replacement.

What is the action of spironolactone in metabolic alkalosis according to the notes?

It is a potassium-sparing diuretic that promotes bicarbonate excretion.

What are the causes of metabolic alkalosis?

Excessive vomiting, nasogastric suctioning, diuretic use, excessive urination associated with diuretics or steroids, IV bicarbonate administration, and hypokalemia.

How does hypokalemia contribute to metabolic alkalosis?

Hydrogen ions move into cells as potassium shifts out, making the blood less acidic.

What should nurses monitor in metabolic alkalosis?

Potassium and chloride levels, neurological status, cardiac rhythm, and ABG results.

What symptoms should nurses watch for in metabolic alkalosis?

Confusion, muscle twitching, cramps, and seizures.

What diagnostic tests are used for metabolic alkalosis?

ABG, electrolyte testing, and CMP.

What ABG values indicate metabolic alkalosis?

pH above 7.45 and HCO₃ above 26 mEq/L.

What is respiratory acidosis?

A condition in which blood becomes too acidic because carbon dioxide (CO₂) builds up in the body.

What are the ABG findings for respiratory acidosis?

pH below 7.35 and PaCO₂ above 45 mmHg.

What are the expected findings of respiratory acidosis?

Shortness of breath, rapid and deep breathing, headache, confusion, drowsiness, fatigue, anxiety, tremors, flushed skin, and sweating.

What are the main treatment goals for respiratory acidosis?

Improve ventilation and respiration, remove airway restrictions, address oversedation when indicated, and treat the underlying cause.

What respiratory support methods may be used for respiratory acidosis?

BiPAP, CPAP, oxygen therapy, and mechanical ventilation, when indicated.

What is BiPAP?

Bilevel positive airway pressure.

What is CPAP?

Continuous positive airway pressure.

What treatments are listed for respiratory acidosis?

Nebulizer treatments, bronchodilators, diuretics, sodium bicarbonate, oxygen therapy, mechanical ventilation, and respiratory support, as indicated by the underlying cause.

What medication categories are listed for respiratory acidosis?

Bronchodilators, diuretics, and sodium bicarbonate.

What causes respiratory acidosis?

Hypoventilation, asthma, COPD, respiratory muscle weakness, narcotic overdose, chest injuries, congestive heart failure, and decreased respirations due to anesthesia, alcohol, or sedatives.

How does hypoventilation cause respiratory acidosis?

Inadequate ventilation causes CO₂ to build up in the body.

How can narcotic overdose cause respiratory acidosis?

It can decrease respirations, causing CO₂ retention.

What should nurses monitor in respiratory acidosis?

Blood pH, CO₂ levels, vital signs, neurological status, and respiratory status.

What diagnostic tests are listed for respiratory acidosis?

ABG and CMP.

What ABG values indicate respiratory acidosis?

pH below 7.35 and PaCO₂ above 45 mmHg.

What is respiratory alkalosis?

A condition in which blood becomes too alkaline because too much CO₂ is removed through rapid breathing.

What are the ABG findings for respiratory alkalosis?

pH above 7.45 and PaCO₂ below 35 mmHg.

What are the expected findings of respiratory alkalosis?

Hyperventilation, shortness of breath, dizziness, confusion, anxiety, numbness or tingling, palpitations, nausea, vomiting, and seizures.

What muscle symptoms may occur with respiratory alkalosis?

Muscle cramps and twitching.

How can respiratory alkalosis affect the heart?

It can cause changes in heart contractility.

What electrolyte imbalances may occur with respiratory alkalosis?

Decreased potassium and chloride.

How can respiratory alkalosis affect bones?

Calcium release from bones may contribute to osteoporosis or fractures.

What can respiratory alkalosis do to glucose use?

It can cause changes in the body's ability to use glucose for energy.

What are the main treatments for respiratory alkalosis?

Identify and treat the underlying cause, reassure the patient, explain symptoms, remove stressors, help slow breathing, administer oxygen when indicated, and manage fluids.

What should nurses do when a patient is hyperventilating due to respiratory alkalosis?

Reassure the patient, explain the symptoms, remove stressors, and help slow breathing.

What medications are listed for respiratory alkalosis?

Sedatives and beta-blockers.

What causes respiratory alkalosis?

Hyperventilation, anxiety, panic attacks, pain, fever, high altitude, mechanical ventilation, lung disease, asthma, COPD, pulmonary embolism, metabolic disorders, liver failure, kidney failure, salicylate poisoning, and medications such as diuretics, aspirin, and salicylates.

How does hyperventilation cause respiratory alkalosis?

It expels too much CO₂, making the blood more alkaline.

What should nurses monitor in respiratory alkalosis?

Electrolytes, renal function, vital signs, blood pH, PaCO₂, and neurological status when indicated.

What laboratory values help identify respiratory alkalosis?

ABG values showing pH above 7.45 and PaCO₂ below 35 mmHg.

What is the main difference between metabolic alkalosis and respiratory alkalosis?

Metabolic alkalosis involves excessive bicarbonate or loss of acid, while respiratory alkalosis results from excessive CO₂ removal.

What is the main difference between respiratory acidosis and respiratory alkalosis?

Respiratory acidosis involves CO₂ buildup and pH below 7.35, while respiratory alkalosis involves excessive CO₂ removal and pH above 7.45.