lecture 1 acid bases

principles of acid base

as the pH goes so goes my patient (except K+)


high pH (basic/alkalosis)

• body system gets more irritable, hyper-excitable (EXCEPT K+)


• think of a body system and go high: hyper-reflexive (+3, +4 [2 is normal]), tachypnea, tachycardia, borborygmi, seizure


low pH (acidic/acidosis)

body shuts down except for potassium.

think of a system and go low: hypo-reflexive (+1, 0), bradycardia, lethargy, 


obtunded, paralytic illeus, respiratory arrest

kussmaul respirations are present in which acid base disorder?

metabolic acidosis!

remember Mac Kussmaul! it’s a compensatory respiratory mechanism.

examples of metabolic alkalosis

prolonged gastric vomiting/suctioning

examples oof metabolic acidosis

hyperemesis graviderum with dehydration, acute renal failure, infantile diarrhea, other diarrhea

high pressure alarm

increased resistance to airflow, machine has to push too hard to get air into lungs usually d/t to obstructions such as:

kinks, water condensation in tube, mucous secretions

when do you suction?

PRN, as needed!

low pressure alarm

decreased resistance to air flow, the machine had to work too little to push air into lungs usually d/t disconnections such as:

main tubing, o2 sensor tubing that senses FiO2

ventilators respiratory alkalosis

ventilation settings are too high leading to over-ventilating

ventilator respiratory acidosis

ventilation settings might be too low which leads to under-ventilating