Respiratory Acid – Base Balance: Operates FAST, in a ...
MU PT 6620, Case Mgmt. -- Pulmonary Obj. #29 Arterial Blood Gas (ABG) Analysis; Acid-Base Balance
| |pH |PaCO2 |HCO3 - |Treatment |
|Respiratory: |Alkalosis |↑ |↓ | |Pain mgmt, sedation, progressive relaxation, |
|pH & PaCO2 are| | |Resp. Alkalosis | |diaphragmatic breathing, |
|INVERSE |S&S: | |Caused by: | |Put paper back over head to re-breathe CO2 |
|Lungs – |Syncope, dizziness, N&V, | |Alveolar hyperventilation (tachypnea) | | |
|volatile acids|tetany | |Anxiety reaction, pain | | |
|– CO2 (in | | |Midbrain lesion | | |
|minutes) | | | | | |
| |Acidosis |↓ |↑ | |Manage secretions: postural drainage & |
| | | |Acute Resp. Acidosis |WNL |percussion, PEP devices. |
| |S&S: | |Alveolar hypoventilation | | |
| |Dyspnea, respiratory | |e.g. pneumonia | | |
| |distress | | | | |
| | | |↑ |Bi-carb comes to the rescue, neutralizing blood |Supplemental oxygen. |
| | |Normal |Compensated Resp. Acidosis |acidity. |… if compensation fails: respiratory failure |
| | |pH |pneumonia (prolonged acute episode) |↑ |requiring mechanical ventilation. |
| | | |COPD (chronic, progressive) | | |
|Metabolic: pH |Alkalosis |↑ | |↑ | |
|& HCO3 are | | | |Metabolic Alkalosis caused by: | |
|DIRECT |S&S: | | |vomiting (loss of stomach acid) | |
|Kidneys |weakness, | | |Antacid abuse | |
|excrete/retain|mental dullness, early | | | | |
|HCO3 - (12-24 |tetany | | | | |
|hrs) | | | | | |
| |Acidosis |↓ | |↓ |Improve glycemic control. |
| | | |WNL |Acute Metabolic Acidosis: |Insulin therapy. |
| |S&S: | | |Diabetic Hyperglycemic Ketoacidosis | |
| |Lethargy, polyuria, | | |Gluconeogenesis (amino acid and fat metabolism) | |
| |polydypsia, polyphagia, | | |Lactic acid | |
| |Dry skin | | | | |
| | | |Alveolar hyperventilation tries to sustain life. Kussmaul’s |↓ |Emergency circumstance. |
| | |Normal |breathing (increased depth & rate) blows off CO2, to reduce |Compensated Metabolic Acidosis |Can progress to coma, death. |
| | |pH |acidity. | | |
| | | |↓ | | |
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