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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