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NUR2392 Multidimensional Care II Exam 2 Graded A+
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NUR2392 Multidimensional Care II Exam 2 Graded A+ Uncompensated pH and one other value is abnormal Partial compensation pH, CO2, and HCO3 are all off Full compensation pH is normal Acidosis reduces the excitability of cardiovascular muscle, neurons, skeletal muscle, and smooth muscle. Alk...

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  • March 29, 2024
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  • 2023/2024
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NUR2392 Multidimensional Care II Exam 2 Graded A+
Uncompensated

pH and one other value is abnormal

Partial compensation

pH, CO2, and HCO3 are all off

Full compensation

pH is normal

Acidosis

reduces the excitability of cardiovascular muscle, neurons, skeletal muscle, and smooth muscle.

Alkalosis

increases the sensitivity of excitable tissues allowing them to OVERRESPOND without stimulation

ABG considerations

- Assess cardiovascular w/ acidosis (cardiac arrest from hyperkalemia)
- Assess neuro status
- Fall precautions

Bicarb HC03

kidney compensation (slow and powerful)

Respiratory PaC02

Respiratory compensation (fast but limited)

Metabolic acidosis causes

DKA, Starvation, diarrhea, kidney failure, dehydration, liver failure, pancreatitis, heavy exercise, seizure
activity, fever, hypoxia, ischemia, ethanol/methanol intoxication

Metabolic acidosis signs and symptoms

bradycardia, hypotension, thready pulse, CNS depression, hyporeflexia, kussmal resp (with resp
compensation), warm, flushed, dry skin.

Metabolic acidosis treatment

hydration and medication to treat underlying problems (DKA - give insulin).

Metabolic alkalosis causes

antacids, blood transfusion, sodium bicarbonate, total parenteral nutrition (TPN), prolonged vomiting,
nasogastric suctioning, hypercortisolism, hyperaldosteronism, Loop/Thiazide diuretics.

, Metabolic Alkalosis s/s

anxiety, irritability, tetany, seizures, POSITIVE CHVOSTEK, POSITIVE TROUSSEAU, parathesis,
hyperreflexia, muscle cramping/twitching, skeletal muscle weakness, Tachycardia, norm/low BP,
increased Digoxin toxicity, decreased respiratory effort (muscle weakness).

metabolic alkalosis treatment

restore fluid/electrolyte imbalances

Respiratory acidosis cause

Opioids, anesthetics, electrolyte imbalance, inadequate chest expansion, muscle weakness, airway
obstruction, alveolar-capillary block.

Respiratory acidosis s/s

bradycardia, hypotension, thready pulse, CNS depression, hyporeflexia, ineffective respirations, pale-to-
cyanotic dry skin.

Respiratory acidosis treatment

(Assess airway) Improve gas exchange, drug therapy (bronchodilators, anti-inflammatory), oxygen
therapy (lowest flow possible), ventilation.

Respiratory alkalosis cause

Hyperventilation (fear, anxiety), mechanical ventilation, salicylate toxicity, high altitudes, early-stage
acute pulmonary issues.

respiratory alkalosis s/s

anxiety, irritability, tetany, seizures, POSITIVE CHVOSTEK, POSITIVE TROUSSEAU (hypocalcemia),
parathesis, hyperreflexia, muscle cramping/twitching, skeletal muscle weakness, Tachycardia, norm/low
BP, increased Digoxin toxicity, hyperventilation

respiratory alkalosis treatment

restore fluid/electrolyte imbalances

How do acid/base imbalances affect electrolytes

- Potassium levels increase in acidosis as the body attempts to maintain electroneutrality during
buffering.
- Potassium is elevated in acute respiratory acidosis and normal/low in chronic respiratory acidosis when
kidney compensation is present
- Alkalosis = hypocalcemia and hypokalemia
- Acidosis = HYPERkalemia

alkalosis

hypocalcemia and hypokalemia

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