Exam_1_Nursing_Skills

Exam 1 Nursing Skills

Acid-Base Balance
 Bicarbonate Buffer system- 22-26 mEq/L, regulates acid-base balance, alkaline buffer
decreases acid in the blood
 Respiratory System- lungs control PCO2 (35-45mmhg), lungs control the retention and
elimination of carbon dioxide and acid, when CO2 increases the rate and depth of
respirations increase to eliminate more CO2, as CO2 is exhaled carbonic acid decreases
thus pH becomes more alkaline, when CO2 decreases the respiratory rate and depth
decreases to retain more CO2 thereby maintain the delicate balance
 Renal System- controlled by kidneys, control the retention and elimination of hydrogen,
acid and sodium bicarbonate, if alkalosis present, kidneys retain hydrogen and excrete
bicarbonate ions in effort to return to a balanced state

Metabolic Acidosis
Decreased ability of kidney to excrete acid or conserve base
PH  7.35 & PCO2  45
 Headache
 Decreased BP
 Hyperkalemia
 NV
 Muscle twitching
 Confusion/Drowsiness
Causes: Severe Diarrhea, renal failure, shock, and DKA

Metabolic Alkalosis
Decrease in acid or increase in base
PH  7.45 & HCO3  26
 Restlessness followed by lethargy
 Tachycardia
 Compensatory Hypoventilation
 Confusion/Dizzy
 NV
 Tremors/ muscle cramps/ tingling of the fingers
 Hypokalemia
Causes: severe vomiting, Excessive GI suctioning, Diuretics, Excessive NaHCO3

Respiratory Alkalosis
Loss of Co2 from lungs
Ph  7.45 & CO2  35
 Seizures
 Deep, rapid breathing

,  Hyperventilation
 Tachycardia
 Low BP to normal BP
 Numbness/ tingling
 NV
 Light headedness
 Lethargy & Confusion
 Hypokalemia
Causes: Hyperventilation, anxiety, fear, and pulmonary embolism, mechanical Ventilation

Respiratory Acidosis
Retention of CO2 by lungs
 PH 7.35 & PCO2 45
 Drowsiness/ dizziness
 Muscle weakness
 Dyspnea
 Headache
 Hyperkalemia
 Dysrhythmias
 Hypoventilation
 Rapid, shallow respirations
Causes: decreased respiratory stimuli (anesthesia, drug overdose, COPD, pneumonia, &
atelectasis

Electrolytes Imbalances
Hyponatremia
 Sodium is less than 135mEq/L, sodium decreases caused by dilution as a result of excess
H2O or Na loss

Signs & Symptoms
 Lethargy
 Headache
 Confusion
 Apprehension
 Seizures
 Dry mucosa
 Thirsty
 Fever
 Tachycardia/ decreased BP
Causes: Vomiting, Diuretics, Inadequate salt intake, diarrhea, GI suctioning & fluid shift from ICF
to ECF