Lydia Gill
Acid Base Case Study
1. Correctly identify which acid-base imbalances go with the appropriate disorder.
Hyperventilation – respiratory alkalosis
Diuretic Therapy – metabolic alkalosis
Atelectasis – respiratory acidosis
Acetylsalicylic Acid (aspirin) Poisoning – respiratory alkalosis then metabolic acidosis
Body is compensating
Massive Transfusion of Whole Blood - metabolic alkalosis (blood is alkaline)
Severe Diarrhea – metabolic acidosis
Pain – respiratory alkalosis
Excessive Vomiting – metabolic alkalosis
Brain Injury – respiratory acidosis
Gastrointestinal Suctioning – metabolic alkalosis
Renal Failure- metabolic acidosis
2. Acid-Base Imbalances: What Are Your Nursing Interventions?
Develop a set of nursing interventions for each of the acid-base imbalances, respiratory
acidosis, respiratory alkalosis, metabolic acidosis, metabolic alkalosis.
They should have at least 3 to 4 interventions for each imbalance.
Respiratory Acidosis:
1. Assess and monitor breath sounds, cardiac rhythms and vital signs
2. Give pt a bronchodilator to open airways
3. Give pt oxygen to increase respiratory rate and lift the head of the bed, suction if
needed
4. Hold all meds that decrease respirations
Respiratory Alkalosis:
1. Give pt a rebreather
2. Encourage pt to take deep breaths
3. Monitor vitals and respiratory rates and labs (ABGs)
4. Have calcium gluconate available for tetany
Metabolic Acidosis/Non-Diabetic:
1. Administer sodium bicarbonate
2. Monitor level of consciousness and neurological functioning
3. Monitor labs for renal functions
4. Administer a BIPAP to control breathing and respiration rates
Diabetic Ketoacidosis: (some people go into DKA around 400, prolonged uncontrolled diabetes
that number may increase)
1. Administer insulin
2. Monitor vitals
3. Monitor signs of circulatory collapse and shock
Metabolic Alkalosis:
1. Monitor level of consciousness
2. Monitor potassium levels and administer potassium rider if necessary
3. Administer meds that promote kidney excretion of bicarb