Imperial Valley College
Division of Nursing Education and Health Technologies
VN 112
Module C-2: Acid-Base: Introduction to Acidosis and Alkalosis
1.
Statement of Purpose
As nurses become increasingly involved in physical assessment of their clients, a
comprehensive knowledge of significant signs and symptoms becomes an essential
module to build on the normal physiological principles of the acid-base balance
process, its pathologies and treatment. By understanding these principles the student
will be better able to anticipate, observe for, and report imbalances that may occur, as
well as to relate the principles to assessment of physiological alterations. This module
emphasizes both the assessment of acid-base imbalances and the nursing care
involved.
2.
Terminology
Review terminology for Module C-1
Metabolic alkalosis
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis
3.
Classroom Content
3.1
Classroom Objectives
a.
b.
c.
d.
e.
f.
g.
h.
i.
Identify metabolic and respiratory acidosis and alkalosis, given laboratory
values for arterial blood gases.
Describe signs and symptoms of metabolic acidosis and alkalosis for
clients of all ages.
Describe signs and symptoms of respiratory acidosis and alkalosis for
clients of all ages.
Identify altered function in metabolic acidosis caused by diabetes, renal
insufficiency/failure, severe diarrhea, and malnutrition.
Identify altered function in metabolic alkalosis caused by ingestion of
excess sodium bicarbonate, excessive vomiting, gastric lavage or levin
tube, and administration of potent diuretics.
Identify altered function in respiratory acidosis caused by emphysema,
sedatives (narcotics), pneumonia, and brain trauma.
Identify altered function in respiratory alkalosis caused by hysteria, drugs
(acetylsalicylic acid), oxygen-lack, and ventilators.
Analyze data from a given situation and identify the acid base
imbalance.
Discuss concept map development in a client with an acid-base
imbalance.
3.2
Learning Activities
a.
b.
c.
d.
e.
f.
g.
h.
3.3
References
a.
b.
c.
d.
e.
f.
4.
Kozier, Fundamentals of Nursing
Anatomy & Physiology text.
Doenges, Nursing Care Plans.
Videotapes & CAI as assigned.
Springhouse,Fluids & Electrolytes Made Incredibly Easy
Hogan, Fluids, Electrolytes, & Acid-Base Balance, Reviews & Rationales
Clinical Objectives
a.
b.
c.
d.
e.
5.
Know terminology.
Review the major acid and base by-products of cellular metabolism
Review the chemical symbols of sodium, chloride, potassium, hydrogen,
oxygen, ammonia, ammonium, carbon dioxide, carbonic acid, and
bicarbonate.
Review the relationship between hydrogen ions and normal pH, acidosis
and alkalosis.
Review the interaction between the body's chemical buffers, lungs, cells
and kidneys
Review assigned chapters in Kozier, Fundamentals of Nursing
View videotapes as assigned.
Complete CAI as assigned.
Given a client=s lab values for arterial blood gases, identify normals, deviations
from normal, and label these deviations as either metabolic or respiratory
alkalosis or acidosis
Reflect on the concept map, the nursing interventions appropriate to the
client care situation.
Administer medication (not IV') to the assigned client.
Complete a concept map on the assigned client.
Apply principles of Standard Precautions to the assigned client.
Skills Laboratory Requirements
Continue skills form Modules A, B-1,B-2, C-1.
Imperial Valley College
Division of Nursing Education and Health Technologies
VN 112
Study Guide Module C-2
Introduction to Acidosis/Alkalosis
I.
II.
III.
IV.
V.
VI.
Acid-Base Balance
A. General information
B. Definitions
1. Alkalosis
2. Acidosis
3. pH
C. Buffer systems
1. Carbonic Acid-Sodium Bicarbonate
2. Protein
3. Phosphate
Acid-Base Imbalances
A. General information
B. Respiratory imbalances
1. Respiratory acidosis
a. Definition
b. What happens
c. Compensation
2. Respiratory alkalosis
a. Definition
b. What happens
c. Compensation
C. Metabolic imbalances
1. Metabolic acidosis
a. Definition
b. What happens
c. Compensation
2. Metabolic alkalosis
a. Definition
b. What happens
c. Compensation
D. Blood gas disturbances
E. Fluid balance disturbances
1. ECF deficit
2. ECF excess
3. Plasma -- interstitial shift
4. Interstitial -- plasma shift
Respiratory Acidosis
A. Causative conditions
B. Nursing observations
Respiratory Alkalosis
A. Causative conditions
B. Nursing observations
Metabolic Acidosis
A. Causative Conditions
B. Nursing observations
Metabolic Alkalosis
A. Causative Conditions
B. Nursing observations