NSG 223 Exam #2 | STUDY GUIDE
Metabolic Acidosis: ABG interpretation - low bicarbonate level less than 22 mEq/L and a low pH less than 7.35.
The cardinal feature is a decrease in the serum bicarbonate level.
Metabolic Alkalosis: ABG interpretation - pH greater than 7.45 and a serum bicarbonate concentration greater
than 26
Respiratory Acidosis: ABG interpretation - pH is less than 7.35 and PaCO2 is greater than 45 and a
compensatory increases HCO3
Respiratory Alkalosis: - pH is greater than 7.45 and the PaCO2 is less than 35
Treatments for Metabolic Acidosis Medical - Give Bicarb
Management: - Chronic metabolic acidosis treat calcium levels first
- Avoid tetany
- Watch for hypernatremia, hyperkalemia, and hypocalcemia
Treatments for Metabolic Alkalosis Medical - Restore fluid volume
Management: - Give electrolytes as needed (Sodium chloride and Potassium chloride)
- Give Tagamet
- Hypokalemia- Urine Chloride, ID the cause
Treatments for each ABG Imbalance: Acute - Underlying cause
Respiratory Acidosis - Bronchodilators
- BiPAP
Treatments for each ABG Imbalance: - Antibiotics
Chronic Respiratory Acidosis - Diuretics
- Bronchodilators
- Corticosteroids
- Mechanical ventilation
,Treatments for each ABG Imbalance: Respiratory - Breathe into a bag- raise CO2
Alkalosis - Reassure patient
- Pursed lip breathing
Acute and Chronic causes of the 4 imbalances: - Build up of acid in the body due to kidney failure or disease
Metabolic Acidosis - Kidneys are unable to remove enough acid from your blood
- Hypocalcemia
Acute and Chronic causes of the 4 imbalances: - High pH, high plasma bicarbonate concertation
Metabolic Alkalosis - Gastric suctioning, vomiting, diuretic use from potassium loss,
Cushing’s syndrome, long term diuretic and antacid use.
Acute and Chronic causes of the 4 imbalances: - Hypoventilation- inadequate excretion of CO2, High CO2 levels
Respiratory Acidosis - Acute pulmonary edema, Severe pneumonia, and acute
respiratory distress syndrome
- Chronic hypercapnia- excessive CO2 in the blood
- Chemoreceptors in your brain alerted to elevated CO2- Ventilation
Acute and Chronic causes of the 4 imbalances: - Hyperventilation- panic attack or anxiety, Low CO2 levels
Respiratory Alkalosis - Asthma
- COPD
- PE
Clinical manifestations of the 4 imbalances: - Headache
Metabolic Acidosis - Confusion
- Increased respiratory rate and depth
- Hypotension
- Cool clammy skin
- Dysrhythmias
Clinical manifestations of the 4 imbalances: - Hypercalcemia
Metabolic Alkalosis - Hypertonic muscles
- Depressed respirations
- Hypokalemia
- Decreased motility and paralytic ileus
- Potassium decreases- PVCs or U waves are seen on ECCG
Clinical manifestations of the 4 imbalances: Acute - Wheezing
Respiratory Acidosis - Blurred vision
- Cyanosis in hands and feet
Clinical manifestations of the 4 imbalances: - Memory loss
Chronic Respiratory Acidosis - Coordination problems
- Sleepiness and headaches- obstructive sleep apnea
- Heart failure
- Polycythemia
- Pulmonary hypertension
, Clinical manifestations of the 4 imbalances: - Numbness or muscles spasm in hands and feet
Respiratory Alkalosis - Tingling in the arms
- SOB
- lightheaded
Metabolic Acidosis: ABG interpretation - low bicarbonate level less than 22 mEq/L and a low pH less than 7.35.
The cardinal feature is a decrease in the serum bicarbonate level.
Metabolic Alkalosis: ABG interpretation - pH greater than 7.45 and a serum bicarbonate concentration greater
than 26
Respiratory Acidosis: ABG interpretation - pH is less than 7.35 and PaCO2 is greater than 45 and a
compensatory increases HCO3
Respiratory Alkalosis: - pH is greater than 7.45 and the PaCO2 is less than 35
Treatments for Metabolic Acidosis Medical - Give Bicarb
Management: - Chronic metabolic acidosis treat calcium levels first
- Avoid tetany
- Watch for hypernatremia, hyperkalemia, and hypocalcemia
Treatments for Metabolic Alkalosis Medical - Restore fluid volume
Management: - Give electrolytes as needed (Sodium chloride and Potassium chloride)
- Give Tagamet
- Hypokalemia- Urine Chloride, ID the cause
Treatments for each ABG Imbalance: Acute - Underlying cause
Respiratory Acidosis - Bronchodilators
- BiPAP
Treatments for each ABG Imbalance: - Antibiotics
Chronic Respiratory Acidosis - Diuretics
- Bronchodilators
- Corticosteroids
- Mechanical ventilation
,Treatments for each ABG Imbalance: Respiratory - Breathe into a bag- raise CO2
Alkalosis - Reassure patient
- Pursed lip breathing
Acute and Chronic causes of the 4 imbalances: - Build up of acid in the body due to kidney failure or disease
Metabolic Acidosis - Kidneys are unable to remove enough acid from your blood
- Hypocalcemia
Acute and Chronic causes of the 4 imbalances: - High pH, high plasma bicarbonate concertation
Metabolic Alkalosis - Gastric suctioning, vomiting, diuretic use from potassium loss,
Cushing’s syndrome, long term diuretic and antacid use.
Acute and Chronic causes of the 4 imbalances: - Hypoventilation- inadequate excretion of CO2, High CO2 levels
Respiratory Acidosis - Acute pulmonary edema, Severe pneumonia, and acute
respiratory distress syndrome
- Chronic hypercapnia- excessive CO2 in the blood
- Chemoreceptors in your brain alerted to elevated CO2- Ventilation
Acute and Chronic causes of the 4 imbalances: - Hyperventilation- panic attack or anxiety, Low CO2 levels
Respiratory Alkalosis - Asthma
- COPD
- PE
Clinical manifestations of the 4 imbalances: - Headache
Metabolic Acidosis - Confusion
- Increased respiratory rate and depth
- Hypotension
- Cool clammy skin
- Dysrhythmias
Clinical manifestations of the 4 imbalances: - Hypercalcemia
Metabolic Alkalosis - Hypertonic muscles
- Depressed respirations
- Hypokalemia
- Decreased motility and paralytic ileus
- Potassium decreases- PVCs or U waves are seen on ECCG
Clinical manifestations of the 4 imbalances: Acute - Wheezing
Respiratory Acidosis - Blurred vision
- Cyanosis in hands and feet
Clinical manifestations of the 4 imbalances: - Memory loss
Chronic Respiratory Acidosis - Coordination problems
- Sleepiness and headaches- obstructive sleep apnea
- Heart failure
- Polycythemia
- Pulmonary hypertension
, Clinical manifestations of the 4 imbalances: - Numbness or muscles spasm in hands and feet
Respiratory Alkalosis - Tingling in the arms
- SOB
- lightheaded
