Lecture on Acid-Base Imbalances

Introduction

• Speaker: Maris
• Focus: Acid-base imbalances
• Materials: Fundamentals of Nursing flashcards (card number 99)
• Additional resources: Arterial Blood Gas deck, Lab Values deck available at leveluprn.com

Review of Expected Lab Values

• pH:
  • Normal Range: 7.35 - 7.45
  • <7.35 indicates acidosis

  • 7.45 indicates alkalosis

• Carbon Dioxide (CO2):
  • Partial pressure should be between 35 - 45
  • Higher levels indicate acidity
  • Lower levels indicate basicity (opposite of pH/bicarbonate)
• Bicarbonate (HCO3):
  • Normal Range: 21 - 28
  • <21 indicates acidity

  • 28 indicates alkalosis

Respiratory Imbalances

Respiratory Alkalosis

• Identification:
  • pH > 7.45
  • PaCO2 < 35
• Causes:
  • Hyperventilation (anxiety, pain, neurological disorders/injury)
• Treatment:
  • Calm the patient
  • Cupped hands or paper bag breathing to increase blood CO2

Respiratory Acidosis

• Identification:
  • pH < 7.35
  • PaCO2 > 45
• Causes:
  • Air trapping disorders (COPD)
  • Over sedation (anesthesia, opioid/benzodiazepine overdose)
  • Mechanical ventilation settings too low
• Treatment:
  • Increase breathing frequency (adjust ventilator settings, wake patient)
  • Administer antidotes like naloxone or flumazenil

Metabolic Imbalances

Metabolic Alkalosis

• Identification:
  • pH > 7.45
  • Bicarbonate > 28
• Causes:
  • Antacid overdose
  • Vomiting or excessive GI suctioning
• Treatment:
  • Address underlying cause (e.g., stop antacid intake)

Metabolic Acidosis

• Identification:
  • pH < 7.35
  • Bicarbonate < 21
• Causes:
  • Diabetic ketoacidosis (DKA)
  • Kidney failure
  • Excessive diarrhea
• Treatment:
  • Depends on the cause (insulin for DKA, antiemetics for vomiting)

Conclusion

• Encouragement to explore further materials for in-depth understanding
• Upcoming topics: Macronutrients, micronutrients, and BMI
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