Acid-Base
Monday, September 11, 2023
9:10 AM
ATI ch. 17 pg 105 chart 17.2 ABG measures
10-15 questions on acid-base
 Acids release hydrogen ion and bases take up hydrogen ion (H+)
 The lungs work quicker but the kidneys work better when it comes to compensation
 Respiratory Acidosis
○ Comes from alveolar hypoventilation
○ Lungs unable to excrete CO2
○ Excess carbonic acid in the blood decreases pH
○ Related problems
 Stroke
 Overdose
 Aspiration
 Pneumonia
 Acute respiratory distress syndrome
 Cardiac arrest
 Chronic obstuctive pulmonary disease
 Hypoventilation
 Neuromuscular disorders
○ Treatment
 Chest physiotherapy
 Suction
 Increase resp rate
 Increased tidal volume
 Respiratory Alkalosis
○ Comes from alveolar hyperventilation
○ Lungs excretes too much CO2
○ Deficit of carbonic acid in the blood increases pH
○ Related problems
 Anxiety
 Fear
 Head trauma
 Brain tumor
 Hepatic insuffficency
 Fever
 Hyperventillation
 Pulmonary embolism
 Thyrotoxitosis
○ Treatment
 Sedation
 Support
 Breathe in paper bag for hyperventilating person
 Decrease resp rate and tidal volume
 Metabolic Acidosis
○ Increase in metabolic acid or decrease in base (bicarbonate
○ Kidneys are unable to excrete enough metabolic acids which accumulate in the blood
○ Results in decreased level of consciousness
○ Related Problems
 Renal failure
 TPN
 Ketoacidosis
□ Type 1 diabetes
 Lactic acidosis
○ Treatment
 Treat underlying cause
 Monitor I&O and dysthythmias
 Protect against infection
 Metabolic Alkalosis
○ Arises from direct increase in base (bicarb) or decrease in metabolic acid
○ Results in increased bicarb
○ Related Problems
 Volume depletion
□ Vomit, diarrhea, gastric suction, diuretic
 NG tubes
□ Losing acid from stomach
Treatment
□ Treat underlying cause
□ Monitor I&O
□ Potassium replacement therapy
 Kidneys cannot compensate for the lungs and the lungs cannot compensate for the kidneys
 pH below 6.9 or higher than 7.8 is usually fatal
○ Renal failure patients might be the exception to this because their bodies are used to this
change in pH
 Respiratory system is more sensitive to acid-base changes because it works so quickly
 Know difference between hyperkalemia and hypokalemia and their symptoms
 ROME
○ Respiratory Opposite Metabolic Equal
 Means respiratory values are in opposite direction of pH
 For metabolic bicarb and pH go in same direction

○ If pH and bicarb or going in different directions then the body is compensating
○ If the pH is in within normal limits then the body has compensated even if the other levels
aren't completely within normal limits