Acid Base Imbalances + ABGs II
Pathophysiology Course
Respiratory Acidosis & Alkalosis - Causes
O2 in
Recall the patho & memory tricks
- Carbon Dioxide CO2
- Think “Carbon diACID” since it pushes the body into acidosis.
CO2 out
Hypoventilation (low & slow breathing) = HIGHER CO2
Hyperventilation (fast breathing) = Lower CO2
Over 7.45 pH
Under 7.35 pH
Respiratory Acidosis = Low & Slow RR
Sleep apnea
Respiratory Alkalosis = Fast RR
Panic Attack
Key Manifestations
• Low PaCO2
• Low HCO3
Compensation:
• Kidneys excrete LESS H+
& reabsorb LESS HCO3
Head trauma “knocked out”
Post-operative
Drugs = CNS depressants
• Opioid overdose NCLEX TIP
• Alcohol intoxication
• Benzodiazepines (Diazepam)
Pneumonia
COPD or Asthma attack
Key Manifestations
• Mental Status changes
• Elevated PaCO2
• Elevated HCO3
Compensation:
• Kidneys excrete H+ (acid)
& retain HCO3 (base)
Top Missed Exam Question
The nurse expects which client
to be in respiratory acidosis?
MEMORY TRICKS
Respiratory ACIDosis
Low & Slow RR
1. Morphine overdose
pH
Respiratory ALKalosis
Respiratory ACIDosis
Fast RR
2. Panic attack
3. Sleep apnea
4. COPD
5. Asthma attack
6. Alcohol intoxication
alk alk alk
alk-alooosis
CO2
Common NCLEX question
CO2
How does the nurse expect the client to
show compensation for the following
ABG values?
Ph 7.20, PaO2 82 mm Hg, PaCO2 37 mm
Hg, HCO3 15 mEq/L
(metabolic acidosis)
1. Decreased respiratory rate
5
6 7
8
9
10
13 14
0 1
2
3
4
12
Think of a person
panting like a dog
(hyperventilation),
it sounds like
“ALK, alk, alk-alosis”
11
Snoring &
hypoventilation
sounds like
“Accccccid-osis”
Acidotic
7.35 pH
2. Increased respiratory rate
3. Increased renal retention of H+…
pH
NORMAL pH
Alkalotic
7.45 pH
4. Decreased renal excretion of HCO3