Acid Base Chart NUR1040 PDF

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Summary

ACID-BASE BALANCES, SIGNS AND SYMPTOMS, INTERVENTIONS...

Description

Acid-Base Disturbances Acid Base

Causes

Imbalance Respiratory Acidosis

Under elimination of H ions.

. Decreased muscle tone & deep tendon reflexes . Increased HR . Shallow, rapid respirations

. Over production of H ions .Under elimination of H ions (DKA, starvation, hyper metabolism) . Under production of Bicarbonate (Renal Failure, dehydration) . Over elimination of bicarbonate(Diarrhea) . Under elimination of H ions

. Decreased muscle tone & deep tendon reflexes . Increased HR . Kussmaul breathing until compensatory response

Respiratory Alkalosis

Metabolic Alkalosis

Compensatory Mechanism

Metabolic Acidosis

Clinical Manifestations

. Excessive loss of CO2 . Hyperventilation . Hypoxemia . Increase in base components (antacids, IV administrations) . Decreased acid (prolonged vomiting, suctioning, Diuretics)

. Kidneys excrete excess H ions . Bicarbonate formed in the renal tubules and eventually retained by the body. . Urine becomes very acidic . pH rises

. Respirations – rapid and deep to eliminate CO2 . pH rises

Laboratory

Nursing Management

Diagnostics pH 45 mmHg HCO3 > 28 mEq/L or normal, during early onset before compensation

. Monitor ABGs . Maintain patient airway . Provide oxygen therapy . Pulmonary hygiene

pH normal but rising

(quick compensatory response, but temporary effectiveness)

HCO3 < 21 mEq/L

. Anxiety . Irritability . Increased Heart Rate . Respirations-Increased rate and depth

. Kidneys excrete Bicarbonate and retain H ions .(longer process – hours to days) Very effective compensatory response

pH >7.45 PaCO2 7.45 PaCO2 normal but rising HCO3 - > 28 mEq/L

. Monitor ABGs . IV hydration . Drugs to correct underlying causes (Insulin for DKA, anti-diarrhea medications)

. Monitor ABGs . Monitor for / treat hyperventilation . Monitor cardio-pulmonary status . Monitor ABDs . Avoid administering alkaline substances . Maintain IV & provide hydration...