Understanding Metabolic Acidosis

Sep 28, 2024

Metabolic Acidosis Lecture Notes

Overview

  • Discussion on metabolic acidosis
  • Lab values reference for:
    • Uncompensated metabolic acidosis
    • Partially compensated metabolic acidosis
    • Fully compensated metabolic acidosis
  • Causes, symptoms, and treatment of metabolic acidosis

Diagnosis through Lab Values

General

  • pH < 7.35 indicates acidosis
  • Evaluate PaCO2 and HCO3 to determine cause

Uncompensated Metabolic Acidosis

  • PaCO2: Normal (35-45)
  • HCO3: Low (<22)
  • Respiratory system is not compensating

Partially Compensated Metabolic Acidosis

  • pH < 7.35 (still acidotic)
  • PaCO2: Low (<35, basic)
  • HCO3: Low (<22)
  • Respiratory system partially compensating

Fully Compensated Metabolic Acidosis

  • pH: Normal, but low side (7.35-7.45)
  • PaCO2: Low (<35, basic)
  • HCO3: Low (<22)
  • Respiratory system fully compensates to normalize pH

Causes of Metabolic Acidosis

  • Diabetic Ketoacidosis (DKA): Common in type 1 diabetics; insufficient insulin leads to fat and protein breakdown, causing acid accumulation.
  • Kidney Failure: Impaired acid excretion
  • Starvation: Breakdown of muscle and fat due to insufficient glucose
  • Diarrhea: Loss of bicarbonate, contributing to acidosis
  • Dehydration, Pancreatitis, Liver Failure
  • Hypermetabolic States: Fever, seizures, heavy exercise

Symptoms of Metabolic Acidosis

  • Cardiovascular: Hypotension, tachycardia, weak pulses
  • Gastrointestinal: Nausea, vomiting
  • Electrolyte Imbalance: Hyperkalemia leading to dysrhythmias
  • Respiratory: Kussmaul respirations (deep, rapid breathing)
  • Other Signs: Fruity odor on breath (indicator of DKA), warm flush skin

Treatment Options

  • Sodium Bicarbonate: To balance acid-base levels
  • IV Fluids: For rehydration
  • Insulin: For DKA, to facilitate glucose uptake into cells
  • Hemodialysis: For patients with kidney failure

Conclusion

  • Importance of understanding metabolic acidosis for nursing students
  • Next topic: Metabolic Alkalosis
  • Encouragement to continue learning

These notes summarize the key points from the lecture on metabolic acidosis, providing a useful reference for understanding the condition, diagnostic criteria, causes, symptoms, and treatment options.