Acid Base pages 13 16 PDF

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II. ACID BASE BALANCE A. Major chemicals you have to remember: 1. Three major chemicals •

Bicarb (Base)

•

Hydrogen (Acid)

•

CO2 (Acid)

2. Major lung chemical: CO2  ________ 3. Kidney chemicals: ________ and ___________________ 4. Too much or too little of these chemicals (CO2, bicarb, hydrogen) can cause an acid base imbalance. B. pH: 1. Normal pH range _________-________ 2. pH less than 7.35 ____________ 3. pH more than 7.45 ____________ 4. The __________________ does not like it when the pH is messed up. 5. If the pH is messed up, it can be dangerous. Alert: A person can die from acidosis or alkalosis. 6. Acidotic person = __________________ Alkalotic person = __________________ 7. Here’s how the body keeps the pH within normal range: _____________________

A CLINICAL JUDGMENT APPROACH | STUDENT MANUAL

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COMPENSATING ORGANS Kidneys Remove excess acid and bicarb by ______________ them through the urine. OR

ACID-BASE BALANCE

Kidneys can ____________ hydrogen and Bicarb and return to the blood. Kidneys take hours to days to do their job.

Lungs One way to get rid of CO2 What is it? _______________ Hyperventilation CO2_______________

Hypoventilation CO2_______________

Lungs respond _______________.

C. Respiratory Acidosis: 1. Pathophysiology: a. Which organ has a problem? ______________ Which organ is going to compensate? ______________ b. What chemical is causing the problem? ___________

NORMAL LAB VALUES: pH: 7.35 - 7.45 PaO2: 80 - 100 mmHg PaCO2: 35 - 45 mmHg HCO3; Bicarbonate:

c. Do we have too much or too little of this chemical in the body? ____________ _____________

22 - 26 mEq/L

d. Hypoventilating or hyperventilating? ________________________________

TESTING STRATEGY: CO2 = LOC CO2 = O2 CO2 and O2 have an inverse relationship.

e. The kidneys are compensating with what chemicals? _____________ and hydrogen

f. The body must ________________ hydrogen. The body will retain bicarb. g. Is the pH high or low? _________

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2. Causes: •

Retain _______________ Mid-abdominal incision, narcotics, sleeping pills, pneumothorax, collapsed lung, and pneumonia

3. Signs/Symptoms: a. Headache, ___________________, sleepy

TESTING STRATEGY: Restlessness think Hypoxia FIRST

b. If not corrected, could lead to a ________________. As the acid increases the level of consciousness goes down.

c. Hypoxic •

Give them ___________________.

•

Early signs and symptoms of hypoxia? _______________ & _______________

4. Treatment: a. Fix the _____________________ problem. b. Pneumonia: Liquefy and mobilize secretions with: •

postural drainage,

•

percussion (vibration therapy),

•

deep breathing exercises,

•

suctioning,

•

fluids,

•

elevate HOB, and

•

incentive spirometry.

c. Pneumothorax client will have _____________ tubes. d. Encourage post-op clients to turn, cough and _______ ___________.

A CLINICAL JUDGMENT APPROACH | STUDENT MANUAL

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D. Respiratory Alkalosis: 1. Pathophysiology: a. Which organ has a problem? ______________ Which organ is going to compensate? ______________ b. What chemical is causing the problem? ___________

ACID-BASE BALANCE

c. Do we have too much or too little of this chemical in the body? _________________ ________________ d. Hypoventilating or hyperventilating? ________________________________ e. Gaining or losing CO2? ____________________ f. Kidneys are compensating with what two chemicals? Bicarb and _________________. g. The body will _______________________ bicarb. The body must ________________ the hydrogen. h. pH? _________________ 2. Causes: a. Problem? ________________________ b. Hysterical (situation) c. Acute aspirin overdose

The client is breathing too ___________, and therefore, removing _____________.

3. Signs/Symptoms: •

Lightheaded or faint feeling, peri-oral numbness, numbness and tingling in fingers and toes.

4. Treatment: a. May have to __________ client to decrease respiratory rate. b. Treat the cause. c. Monitor ABGs.

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