Acid-Base Imbalances and Ventilator Alarms

Vocabulary and principles regarding acid-base imbalances, symptom identification, causes, and ventilator alarm management based on nursing lecture notes.

Alkalosis S/S Rule

As the $pH$ goes up ($pH \to \text{up}$), the patient's symptoms also go up (irritable, hyper-excitable, borborygmi), except for potassium ($K^+$) which goes down.

Acidosis S/S Rule

As the $pH$ goes down ($pH \to \text{down}$), the patient's body shuts down (decreased heart rate, decreased respiratory rate, lethargy), except for potassium ($K^+$) which goes up.

Borborygmi

Hyperactive bowel sounds associated with alkalosis ($pH \to \text{up}$).

Metabolic Imbalance Identification

A condition where the $pH$ and bicarbonate ($HCO_3$) are moving in the same direction.

Respiratory Alkalosis Cause

Caused by over-ventilating (excessive gas exchange).

Respiratory Acidosis Cause

Caused by under-ventilating (inadequate gas exchange).

Metabolic Alkalosis Causes

Resulting from prolonged vomiting or gastric suctioning.

Mac Kussmaul

A specific respiratory pattern seen only in cases of metabolic acidosis.

High Pressure Alarm

A ventilator alarm triggered by increased resistance due to obstructions like kinks in the tubing, water condensation, or mucus in the airway.

Low Pressure Alarm

A ventilator alarm triggered by decreased resistance usually caused by a disconnection in the main tubing or the $O_2$ sensor tubing.

Modifying Phrase Rule

The nursing principle that the clinical status described in a modifying phrase (e.g., "now psychotic" or "now dehydrated") trumps the original noun or diagnosis.

Ventilation (Technical Definition)

Refers specifically to gas exchange rather than just respiratory rate; measured by $SaO_2$.

Alkalosis Risk Management

Requires suction at the bedside due to the risk of seizures.

Acidosis Risk Management

Requires an Ambu bag at the bedside due to the risk of respiratory depression.

Mucus Obstruction Protocol

Sequence of intervention: 1. Turn, 2. Cough, 3. Deep breathe; if these fail, suction as a last resort.