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
- Hyperventilation due to pneumonia: Respiratory acidosis
- DKA: Metabolic acidosis
- Hyperventilation due to anxiety: Respiratory alkalosis
- Antacid overdose: Metabolic alkalosis
Tips: Review flashcards for thorough preparation, repetition is key. Good luck with studying!