Acid-Base Imbalances Lecture

Overview

• Focus on causes, signs, symptoms, and treatment of acid-base imbalances.
• Not covering ABG interpretation in this session.
• Use medical surgical nursing flashcards.
• Includes a quiz at the end to test knowledge.

Respiratory Imbalances

Respiratory Alkalosis

• pH: Above 7.45
• PaCO2: Below 35
• Causes:
  • Hyperventilation due to fear, anxiety, salicylate toxicity (e.g., excess aspirin), high altitude, shock, pain, or trauma.
• Symptoms:
  • Shortness of breath, dizziness, chest pain, numbness in hands/feet.
• Treatment:
  • Correct underlying cause: anti-anxiety meds, pain management.

Respiratory Acidosis

• pH: Below 7.35
• PaCO2: Above 45
• Causes:
  • Hypoventilation due to respiratory disorders (ARDS, asthma, pneumonia, COPD), inadequate chest expansion, respiratory depression (opioids, benzodiazepines).
• Symptoms:
  • Confusion, lethargy, dyspnea, pale/cyanotic skin.
• Treatment:
  • Oxygen, bronchodilators, naloxone (for opioid overdose), mechanical ventilation if needed.

Metabolic Imbalances

Metabolic Alkalosis

• pH: Over 7.45
• HCO3: Over 28
• Causes:
  • Antacid overdose, loss of body acid (vomiting, NG tube suctioning).
• Symptoms:
  • Tachycardia, dysrhythmias, muscle weakness, lethargy.
• Treatment:
  • Correct underlying issue: antiemetics, IV fluid, and electrolyte replacement.

Metabolic Acidosis

• pH: Under 7.35
• HCO3: Under 21
• Causes:
  • Diabetic Ketoacidosis (DKA), kidney failure, starvation, diarrhea, dehydration.
• Symptoms:
  • Hypotension, tachycardia, weak pulses, dysrhythmias, Kussmaul respirations, fruity breath odor.
• Treatment:
  • Sodium bicarbonate, IV fluids and insulin (for DKA), hemodialysis (for kidney failure).

Quiz

• Question 1: Hypoventilation due to pneumonia causes...?
  • Answer: Respiratory Acidosis
• Question 2: DKA causes...?
  • Answer: Metabolic Acidosis
• Question 3: Hyperventilation due to anxiety causes...?
  • Answer: Respiratory Alkalosis
• Question 4: Antacid overdose results in...?
  • Answer: Metabolic Alkalosis

Conclusion

• Use repetition and review flashcards for retention.
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