Acid-Base Imbalance Causes
Resp Acidosis An obstruction of the airway or depresses the resp system : Asthma : Atelectasis : Brain trauma : Bronchiectasis : Bronchitis : CNS depressants : Emphysema : Hypoventilation : Pulmonary edema : Pneumonia : Pulmonary emboli
Resp Alkalosis Overstimulation of the resp system : Fever : Hyperventilation : Hypoxia : Hysteria : Overventilation by mechanical vent : Pain
Metabolic Acidosis DM or diabetic ketoacidosis : ↓ INS causes ↑ fat metabolism Excessive ingestion of aspirin High-fat diet : Too rapid accumulation of the waste products Insufficient metabolism of carbo : ↑ fat catabolism Malnutrition Renal insufficiency or RF Severe diarrhea
Metabolic Alkalosis Diuretics : Compensatory ↑ in the amount of bicarbonate in the blood Excessive vomiting GI suctioning Hyperaldosteronism Intake of excess sodium bicarbonate Massive transfusion of whole blood
Normal: pH = 7.35 – 7.45 PaCO2: 35 – 45 mmHg HCO3-: 22 – 26 mEq/L PaO2: 80 – 100 mmHg
pH: ↓ PaCO2: ↑ HCO3-: Normal or ↑ PaO2: ↓ K+: ↑
pH: ↑ PaCO2: ↓ HCO3-: Normal or ↓ PaO2: Normal K+: ↓
pH: ↓ PaCO2: Normal or ↓ HCO3- : ↓ PaO2: Normal K+: ↑
pH: ↑ PaCO2: Normal or ↑ HCO3-: ↑ PaO2: Normal K+: ↑
Clinical Manifestations
• Neuro
• Neuro : Lethargy : Light-headedness : Confusion • CV : Tachycardia : Dysrhythmias r/t hypokalemia • GI : N&V : Epigastric pain • Neuromuscular : Tetany : Numbness : Seizures • Resp : Hyperventilation
• Neuro : Drowsiness : Confusion : HA : Coma • CV : : ↓ BP : V-fib r/t hyperkalemia : Warm, flushed skin d/t peripheral vasodilation • GI : N&V : Diarrhea : Abd pain • Neuromuscular : None • Resp : Deep, rapid resp (compensatory action) : Hyperpnea w/ Kussmaul’s respiration (abnormally deep, regular, and ↑ in rate) to exhale the excess CO2
• Neuro : Drowsiness : Dizziness : Nervousness • CV : Tachycardia : Dysrhythmias r/t hypokalemia • GI : Anorexia : N&V • Neuromuscular : Tremors : Hypertonic muscles : Muscle cramps : Tetany • Resp : Hypoventilation (compensatory action)
Lab Value Changes
: Drowsiness : Disorientation : Coma • CV : ↓ BP : V-fib r/t hyperkalemia : Warm, flushed skin d/t peripheral vasodilation • GI : None • Neuromuscular : Seizures • Resp : Hypoventilation