Acid Base Imbalances Essay case study PDF

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Zainab Bilal Cohort-June 2019 1/24/21 Acid Base Imbalances 1. Explain the concept of compensation about acid-base balance. The concept of compensation is the physiological change that can occur in acid-base disorders which happen in order to maintain normal body ph. For example, compensatory changes that can occur in the body are metabolic disorders and respiratory disorders. Metabolic disorders tend to trigger rapid compensation within minutes by making changes in ventilation. In respiratory disorders compensation starts slowly over the period of several hours to days. An example of this is when the pH in the urine changes causing a urinary infection.

2. What does it mean to be uncompensated? What does it mean to be compensated? If the pH as well as the values from either PaCO2 or HCO3 become abnormal the body is in an uncompensated state causing either respiratory or metabolic acidosis. Compensated happens when PaCO2 and HCO3 values are high but pH is acidic, then it indicates partial compensation. This indicates that the compensatory mechanism tried but failed to bring the pH to normal. Compensation can also be thought of as the body’s attempt to correct the imbalance.

3. What are the expected reference ranges for arterial blood gas values? Arterial blood gas is one of the most commonly used tests to measure oxygenation and blood acid levels. The test is also used to check the function of the patient’s lungs and how well they are able to move oxygen into the blood and remove carbon dioxide. According to the National Institute of Health, usual values are

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pH: 7.35-7.45

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Partial pressure of oxygen (PaO2): 75 to 100 mmHg

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Partial pressure of carbon dioxide (PaCO2): 35-45 mmHg

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Bicarbonate (HCO3): 22-26 mEq/L

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Oxygen saturation (O2 Sat): 94-100%

4. How would these values fluctuate in a client who has: metabolic alkalosis? metabolic acidosis? respiratory alkalosis? respiratory acidosis? Firstly, the nurse should look at the pH to determine if the patient is in the normal range, above, or below. If a patient’s pH > 7.45, the patient is in alkalosis. If the pH < 7.35, then the patient is acidosis. Therefore, the nurse should know that the lower the pH number, the higher the acid level in the body. In addition, even with a normal pH level, acidosis or alkalosis may still be present, as the body can compensate to balance the ph. Secondly the nurse should check the PaCO2 and determine if the changes in the blood gas are due to the respiratory system or metabolically driven. Based on this information the lab values in metabolic alkalosis will show the blood results to be excessively alkaline. Metabolic acidosis tends to show that there is too much acid in the body fluids. This happens when the chemical balance of acids and bases in the blood gets thrown off. Respiratory alkalosis occurs when you breathe too fast or too deep and

carbon dioxide levels drop too low. This causes the pH in the blood to rise and become alkaline causing the blood to become acidic. Respiratory acidosis happens when the lungs can’t remove carbon dioxide produced by the body causing the pH in the blood and other bodily fluids to decrease making them acidic....