TTC Acid-Base balance

Refers to the amount of hemoglobin in the blood that is saturated with Oxygen

Oxygen Saturation (SpO2)

>7.45

Alkalosis pH

PCO2 >45

Respiratory acidosis

HCO3>26

Metabolic alkalosis

Refers to the acid-base balance of the blood

pH

These cause what?

Alveolar hyperventilation, anxiety, PE, fear, mechanical ventilation

Causes of respiratory alkalosis

These are s/s of what?

Early: rapid shallow respirations, hypoxia, dyspnea, headache

Late: confusion, somnolence, coma

Signs/Symptoms of respiratory acidosis

<7.35

Acidosis pH

These cause what?

Diabetic (severe hyperglycemia (DKA)), lactic, or uremic acidosis, renal failure, prolonged diarrhea, dehydration, liver failure

Causes of metabolic acidosis

HCO3<22

Metabolic acidosis

These cause what?

Bicarbonate ingestion, vomiting, diuretics, steroids, adrenal disease, excessive GI suctioning

Causes of metabolic alkalosis

s/s of what?

Secondary hyperventilation (Kussmauls breathing), nausea and vomiting, cardiac dysrhythmias

Signs/Symptoms metabolic acidosis

Refers to the amount of oxygen in arterial blood

Partial pressure of oxygen (paO2)

PCO2<35

Respiratory alkalosis

Refers to the amount of carbon dioxide in arterial blood

Partial pressure of Carbon Dioxide (PaCO2)

S/S of what?

Vague symptoms: weakness, confusion, possible early tetany, hypokalemia, muscle cramps, nausea, vomiting, diarrhea

Signs/Symptoms metabolic alkalosis

Refers to the total amount of CO2 that is transported in the blood

Bicarbonate (HCO3)

Drowsiness, confusion, syncope, tingling, rapid breathing, numbness, early tetany, hypokalemia, tachycardia

Signs/Symptoms respiratory Alkalosis

these are causes of what?

Alveolar hypoventilation, COPD, drug overdose

Causes of respiratory acidosis

Normal pH range:

7.35-7.45

Partial Pressure of Oxygen (PaO2):

75-100mmHg

Partial pressure of carbon dioxide (PaCO2):

35-45 mmHg

Bicarbonate (HCO3)

22-26 mEq/L

Oxygen Saturation (SpO2):

94-100%

T/F:

An ABG test is routinely used to diagnose and monitor patients who are suffering from critical conditions. Because this test provides a precise measurement of the levels of oxygen and carbon dioxide in the blood, it can help medical professionals determine the status of the patient's lung and kidney function.

True

T/F:

Gastrointestinal losses ABOVE the waist result in the loss of BASE

False - Result in loss of ACID, ABOVE = ACID

T/F:

Gastrointestinal losses BELOW the waist result in the loss of ACID

False - Result in loss of BASE, BELOW = BASE

T/F:

The best test of evaluation of acid-base is ABG's

True

T/F:

A client in metabolic alkalosis will begin to hyperventilate to compensate this will cause the body to retain CO2 and increase the acid in the body

True

T/F:

Gastric suctioning removes gastric acid secretions which will increase the risk of metabolic acidosis

False - Metabolic Alkalosis

T/F:

Increased respiratory rate decreases the expiratory phase of respirations causing carbon monoxide accumulation

False (CARBON DIOXIDE (CO2)) hyperventilation decreases CO2

T/F:

Decreasing the respiratory rate with controlled breathing will help to increase and retain the depleted CO2 level

True

Carbon Dioxide (PaCO2) is being regulated by the:

Lungs

Bicarb (HCO3) is being regulated by the:

Kidneys

Carbon Dioxide (PaCO2) is:

Acid

Bicarb (HCO3) is:

Base

The kidney performs two major functions to assist in acid-base balance. The first is to _________ and return to the body's circulation any ________ from the urinary filter, The second is to ________ acid in the urine.

Reabsorb

Bicarbonate

Excrete

If the patient is hypoventalitating, their CO2 will:

Increase

If the patient is hyperventilating, their CO2 will:

Decrease

List 3 symptomatic reasons the physician may order an ABG

-Breathing difficulties

-Changes in mental status

-Nausea or vomiting

Give 4 assessment problems an ABG test can help with

-To assess whether treatments for lung conditions are effective.

-To check for chemical poisoning

-To check the acid-base balance in patients with kidney disease, diabetes, and those recovering from a drug overdose

-To determine the presence of a ruptured blood vessel or metabolic disease.

Name 3 systems that come into play for maintaining body pH

-Chemical buffers

-Respiratory system

-Kidney - Renal system

Name 4 interventions the nurse should include in plan of care with a patient who is in respiratory alkalosis

-Correct underling cause (for example if nausea and vomiting or diarrhea replenish the fluids, rehydrate as needed)

-Oxygen therapy

-Medication to ease breathing, sedate or help with anxiety

-Paper bag breathing for hyperventilation