NUR2392 Multidimensional Care II Exam 2
Uncompensated pH and one other value is abnormal
Partial compensation pH, CO2, and HCO3 are all off
Full compensation pH is normal
reduces the excitability of cardiovascular muscle, neurons,
Acidosis
skeletal muscle, and smooth muscle.
increases the sensitivity of excitable tissues allowing them
Alkalosis
to OVERRESPOND without stimulation
- Assess cardiovascular w/ acidosis (cardiac arrest from
hyperkalemia)
ABG considerations
- Assess neuro status
- Fall precautions
Bicarb HC03 kidney compensation (slow and powerful)
Respiratory PaC02 Respiratory compensation (fast but limited)
DKA, Starvation, diarrhea, kidney failure, dehydration, liver
Metabolic acidosis causes failure, pancreatitis, heavy exercise, seizure activity, fever,
hypoxia, ischemia, ethanol/methanol intoxication
bradycardia, hypotension, thready pulse, CNS depres-
Metabolic acidosis signs and symptoms sion, hyporeflexia, kussmal resp (with resp compensa-
tion), warm, flushed, dry skin.
hydration and medication to treat underlying problems
Metabolic acidosis treatment
(DKA - give insulin).
antacids, blood transfusion, sodium bicarbonate, total
parenteral nutrition (TPN), prolonged vomiting, naso-
Metabolic alkalosis causes
gastric suctioning, hypercortisolism, hyperaldosteronism,
Loop/Thiazide diuretics.
anxiety, irritability, tetany, seizures, POSITIVE CHVOSTEK,
Metabolic Alkalosis s/s POSITIVE TROUSSEAU, parathesis, hyperreflexia, muscle
cramping/twitching, skeletal muscle weakness, Tachycar-
, dia, norm/low BP, increased Digoxin toxicity, decreased
respiratory effort (muscle weakness).
metabolic alkalosis treatment restore fluid/electrolyte imbalances
Opioids, anesthetics, electrolyte imbalance, inadequate
Respiratory acidosis cause chest expansion, muscle weakness, airway obstruction,
alveolar-capillary block.
bradycardia, hypotension, thready pulse, CNS depression,
Respiratory acidosis s/s hyporeflexia, ineffective respirations, pale-to-cyanotic dry
skin.
(Assess airway) Improve gas exchange, drug thera-
Respiratory acidosis treatment py (bronchodilators, anti-inflammatory), oxygen therapy
(lowest flow possible), ventilation.
Hyperventilation (fear, anxiety), mechanical ventilation,
Respiratory alkalosis cause salicylate toxicity, high altitudes, early-stage acute pul-
monary issues.
anxiety, irritability, tetany, seizures, POSITIVE CHVOSTEK,
POSITIVE TROUSSEAU (hypocalcemia), parathesis, hy-
respiratory alkalosis s/s perreflexia, muscle cramping/twitching, skeletal muscle
weakness, Tachycardia, norm/low BP, increased Digoxin
toxicity, hyperventilation
respiratory alkalosis treatment restore fluid/electrolyte imbalances
- Potassium levels increase in acidosis as the body at-
tempts to maintain electroneutrality during buffering.
- Potassium is elevated in acute respiratory acidosis and
How do acid/base imbalances affect electrolytes normal/low in chronic respiratory acidosis when kidney
compensation is present
- Alkalosis = hypocalcemia and hypokalemia
- Acidosis = HYPERkalemia
alkalosis hypocalcemia and hypokalemia
2/8
Uncompensated pH and one other value is abnormal
Partial compensation pH, CO2, and HCO3 are all off
Full compensation pH is normal
reduces the excitability of cardiovascular muscle, neurons,
Acidosis
skeletal muscle, and smooth muscle.
increases the sensitivity of excitable tissues allowing them
Alkalosis
to OVERRESPOND without stimulation
- Assess cardiovascular w/ acidosis (cardiac arrest from
hyperkalemia)
ABG considerations
- Assess neuro status
- Fall precautions
Bicarb HC03 kidney compensation (slow and powerful)
Respiratory PaC02 Respiratory compensation (fast but limited)
DKA, Starvation, diarrhea, kidney failure, dehydration, liver
Metabolic acidosis causes failure, pancreatitis, heavy exercise, seizure activity, fever,
hypoxia, ischemia, ethanol/methanol intoxication
bradycardia, hypotension, thready pulse, CNS depres-
Metabolic acidosis signs and symptoms sion, hyporeflexia, kussmal resp (with resp compensa-
tion), warm, flushed, dry skin.
hydration and medication to treat underlying problems
Metabolic acidosis treatment
(DKA - give insulin).
antacids, blood transfusion, sodium bicarbonate, total
parenteral nutrition (TPN), prolonged vomiting, naso-
Metabolic alkalosis causes
gastric suctioning, hypercortisolism, hyperaldosteronism,
Loop/Thiazide diuretics.
anxiety, irritability, tetany, seizures, POSITIVE CHVOSTEK,
Metabolic Alkalosis s/s POSITIVE TROUSSEAU, parathesis, hyperreflexia, muscle
cramping/twitching, skeletal muscle weakness, Tachycar-
, dia, norm/low BP, increased Digoxin toxicity, decreased
respiratory effort (muscle weakness).
metabolic alkalosis treatment restore fluid/electrolyte imbalances
Opioids, anesthetics, electrolyte imbalance, inadequate
Respiratory acidosis cause chest expansion, muscle weakness, airway obstruction,
alveolar-capillary block.
bradycardia, hypotension, thready pulse, CNS depression,
Respiratory acidosis s/s hyporeflexia, ineffective respirations, pale-to-cyanotic dry
skin.
(Assess airway) Improve gas exchange, drug thera-
Respiratory acidosis treatment py (bronchodilators, anti-inflammatory), oxygen therapy
(lowest flow possible), ventilation.
Hyperventilation (fear, anxiety), mechanical ventilation,
Respiratory alkalosis cause salicylate toxicity, high altitudes, early-stage acute pul-
monary issues.
anxiety, irritability, tetany, seizures, POSITIVE CHVOSTEK,
POSITIVE TROUSSEAU (hypocalcemia), parathesis, hy-
respiratory alkalosis s/s perreflexia, muscle cramping/twitching, skeletal muscle
weakness, Tachycardia, norm/low BP, increased Digoxin
toxicity, hyperventilation
respiratory alkalosis treatment restore fluid/electrolyte imbalances
- Potassium levels increase in acidosis as the body at-
tempts to maintain electroneutrality during buffering.
- Potassium is elevated in acute respiratory acidosis and
How do acid/base imbalances affect electrolytes normal/low in chronic respiratory acidosis when kidney
compensation is present
- Alkalosis = hypocalcemia and hypokalemia
- Acidosis = HYPERkalemia
alkalosis hypocalcemia and hypokalemia
2/8
