Topic 3 Acid-Base Imbalances

acidosis

pH < 7.35

alkalosis

pH > 7.45

respiratory acidosis

low pH and high CO2

respiratory alkalosis

high pH and low CO2

metabolic acidosis

low pH and low HCO3

metabolic alkalosis

high pH and high HCO3

• atelectasis

• chest wall abnormality

• chronic respiratory disease (COPD)

• mechanical hypoventilation

• severe pneumonia

• Pulmonary edema

• respiratory muscle weakness

• sedative overdose

what can cause respiratory acidosis

• hyperventilation (hypoxia, anxiety, fear, pain, exercise, fever)

• liver failure

• mechanical hyperventilation

• stimulated respiratory center (septicemia, stroke, meningitis, encephalitis, brain injury, salicylate poisoning

what are the causes of respiratory alkalosis

• DKA

• diarrhea

• GI fistulas

• Lactic acidosis

• renal failure

• renal tubular acidosis

• shock

• starvation

What are the causes of metabolic acidosis

• diuretic therapy

• excess NaHCO3 intake

• hypokalemia

• mineralcorticoid use

• NG suctioning

• vomiting

what are the causes of metabolic alkalosis

• lethargy

• confusion

• dizziness

• HA

• coma

• hypotension

• V-fib

• warm, flushed skin

• seizures

• hypoventilation with hypoxia

what are the S/S of respiratory acidosis

• lethargy

• confusion

• dizziness

• HA

• coma

• hypotension

• dysrhythmias

• cold, clammy skin

• N/V, diarrhea, abdominal pain

• muscle weakness

• deep, rapid respirations

what are the S/S of metabolic acidosis

• dizziness

• light-headedness

• confusion

• HA

• tachycardia

• dysrhythmias

• N/V, diarrhea

• epigastric pain

• tetany

• numbness

• tingling of extremities

• hyperreflexia

• seizures

• hyperventilation

what are the S/S of respiratory alkalosis

• irritability

• lethargy

• confusion

• HA

• tachycardia

• dysrythmias

• N/V, anorexia

• tetany

• tremors

• tingling of fingers and toes

• muscle cramps, hypertonic muscles

• seizures

• hypoventilation

what are the S/S of metabolic alkalosis

• fluid volume deficit

• hypocalcemia

• hypermagnesemia

what fluid/electrolyte imbalances can cause hypotension

• fluid volume excess

• hypercalcemia

• hypomagnesemia

what fluid/electrolyte imbalances can cause HTN

• hypocalcemia

• hypomagnesemia

• hyperphosphatemia

what fluid/electrolyte imbalances can cause Chvostek sign

• hyperkalemia

• hypocalcemia

• hypomagnesemia

• hyperphophatemia

what fluid/electrolyte imbalances can cause muscle cramps

• hyper/hypokalemia

• hypercalcemia

• hypophosphatemia

• hypermagnesemia

what fluid/electrolyte imbalances can cause muscle weakness

• hypocalcemia

• hypo/hypermagnesemia

what fluid/electrolyte imbalances can cause Trousseau sign

• fluid volume excess

• hypo/hypernatremia

• hypo/hyperkalemia

• hypocalcemia

• hypo/hypermagnesemia

• hypophosphatemia

what fluid/electrolyte imbalances can cause confusion

• fluid volume deficit or excess

• hypo/hypernatremia

• hypophosphatemia

what fluid/electrolyte imbalances can cause decreased LOC

• fluid volume deficit

• hypokalemia

• hypercalcemia

what fluid/electrolyte imbalances can cause fatigue

• hyponatremia

• hyperkalemia

• hypocalcemia

• hyperphosphatemia

What fluid/electrolyte imbalances can cause irritability

• hypernatremia

• hypokalemia

• hypocalcemia

• hyperphosphatemia

• hypomagnesemia

what fluid/electrolyte imbalances can cause tremors, seizures

fluid volume excess

what fluid/electrolyte imbalances can cause crackles and dyspnea

fluid volume deficit

what fluid/electrolyte imbalances can cause rapid respirations

• hypocalcemia

• hyperphosphatemia

what fluid/electrolyte imbalances can cause restricted airways

fluid volume excess

what fluid/electrolyte imbalances can cause bounding pulse and pitting edema

fluid volume deficit

what fluid/electrolyte imbalances can cause rapid, weak, thready pulse and poor skin turgor

• severe hypokalemia

• hypomagnesemia

what fluid/electrolyte imbalances can cause a weak, irregular, rapid pulse

• severe hyperkalemia

• hypermagnesemia

what fluid/electrolyte imbalances can cause a weak, irregular, slow pulse

• fluid volume deficit

• hyponatremia

what fluid/electrolyte imbalances can cause cold, clammy skin

• hypernatremia

• hypermagnesemia

What fluid/electrolyte imbalances can cause flushed, dry skin

hypertonic solutions

those receiving what solutions need frequent monitoring of BP, lung sounds, and serum sodium levels due to risk for intravascular fluid volume excess

• 5% Dextrose in Water

• 0.9% Saline

• 5% Dextrose in 0.225% Saline

• Ringer’s Solution

• Lactated Ringer’s Solution

what are the isotonic solutions

• 10% Dextrose in Water

• 3.0% Saline

• 5% Dextrose in 0.45% Saline

• 5% Dextrose in 0.9% Saline

what are the hypertonic solutions

0.45% saline

what are the hypotonic solutions