Acid-Base Imbalances Lecture

May 16, 2024

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Acid-Base Imbalances Lecture

Overview

  • Focus on causes, signs and symptoms, and treatment of different acid-base imbalances
  • Not focusing on how to interpret ABGs (Arterial Blood Gases)
  • Suggested using medical-surgical nursing flashcards
  • Ends with a quiz to review key facts

Respiratory Imbalances

Respiratory Alkalosis

  • pH: Above 7.45
  • PaCO2: Below 35
  • Causes:
    • Hyperventilation due to fear, anxiety, salicylate toxicity, high altitude, shock, pain, trauma
  • Symptoms:
    • Shortness of breath, dizziness, chest pain, numbness in hands or feet
  • Treatment:
    • Correct underlying cause
    • Anti-anxiety meds for anxiety
    • Pain medications for pain

Respiratory Acidosis

  • pH: Below 7.35
  • PaCO2: Above 45
  • Causes:
    • Hypoventilation due to ARDS, asthma, pneumonia, COPD
    • Inadequate chest expansion
    • Respiratory depression from opioids or benzodiazepines
  • Symptoms:
    • Confusion, lethargy, dyspnea, pale or cyanotic skin
  • Treatment:
    • Oxygen
    • Bronchodilators (e.g., for asthma)
    • Naloxone for opioid overdose
    • Possible mechanical ventilation

Metabolic Imbalances

Metabolic Alkalosis

  • pH: Over 7.45
  • HCO3 (Bicarbonate): Over 28
  • Causes:
    • Antacid overdose
    • Loss of body acid through vomiting or NG tube suctioning
  • Symptoms:
    • Tachycardia, dysrhythmias, muscle weakness, lethargy
  • Treatment:
    • Correct underlying issue (e.g., antiemetics for vomiting)
    • Provide 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 odor on breath
  • Treatment:
    • Sodium bicarbonate
    • IV fluids and insulin for DKA
    • Hemodialysis for kidney failure

Quiz: Name That Acid-Base Imbalance

  1. Hyperventilation due to pneumonia: Respiratory acidosis
  2. DKA: Metabolic acidosis
  3. Hyperventilation due to anxiety: Respiratory alkalosis
  4. Antacid overdose: Metabolic alkalosis

Tips: Review flashcards for thorough preparation, repetition is key. Good luck with studying!