Acid-Base Imbalance

With the early vomiting, we could expect Mr. K. B’s serum pH to be between 7.4 and 7.45. (VanMeter, Hubert p 32)

A (assessment): Ms. O’Reilly’s vital signs are temperature of 37.5 C, pulse of 112, blood pressure of 102/52, and respirations of 24. Her respirations are still deep but have a regular rhythm. She has a CBS of 8.1 and regular insulin running as per orders. The lab work shows uncompensated metabolic acidosis with no hypoxia. Ms. O’Reilly’s neurological status has improved with a GSC of 13. Her dehydration is being treated with NS containing 40mEQ KCL/L running at 200ml/hr and potassium levels maintained at 4.

Metabolic alkalosis is a condition in which the body fluids have excess base. The kidneys and lungs maintain the proper balance of chemicals, called acids and bases, in the body. Decreased carbon dioxide or increased bicarbonate level makes the body too alkaline. There are different types of alkalosis such as: respiratory alkalosis, which is caused by a low carbon dioxide level in the blood. This can be due to: fever, lack of oxygen, lung disease, or liver disease; hypochloermic alkalosis is caused by an extreme lack or loss of chloride, from prolonged vomiting; hypokalemic alkalosis is caused by the kidneys’ response to an extreme lack of potassium, this can occur from taking certain water pills. Compensated alkalosis occurs when the body returns to the acid-base balance to normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal. Symptoms of alkalosis can include: confusion, hand tremor, light-headedness, muscle twitching, vomiting, and numbness or tingling in the face, hands, or feet. Treatment for alkalosis depends on

To start out this study the difference between acids and bases has to be identified. Acids have very low pHs and have a high concentration of hydronium ions, while bases have a high pH and have a high concentration of hydroxide ions. The difference between strong bases and acids, and weak bases and acids is the amount of dissociation. Strong bases and acids dissociate a large amount and let go of their ions in solution, while weak bases and acids may only let go of some of their ions. This is important because if the unknown solutions aren’t strong acids or bases then using their ions to calculate the pH of the solutions will give false results (Diffen 2012).

4. Why does potassium concentration rise in patients with acidosis? What is this called? What effects does it have?

Primary treatments include antibiotic therapy, Fluid resuscitation, and crystalloid. Potential treatments depending on patient status include vasopressors and steroids, ventilator, renal dialysis, blood transfusion, and surgery.

541). Interventions should be rendered continuously, promptly and appropriately as it can cause life-threatening complications (Holt 2009, p. 26). Apparently, the patient is stable, but continuous assessment and management should be done to avoid recurrences of untoward signs andsymptoms and prevent potential complications. Firstly, continuous assessment and vital signs should be done and these include blood pressure, cardiac rate, respiration, venous distention and skin turgor to assess possible occurrence of fluid overload as a result of rapid administration of large fluid that is often needed to treat the patient with DKA (Smeltzer & Bare 2004 p. 1185). Aside from this, documentation of fluid intake and output should be monitored and documented to assess for circulatory overload and renal function (Holt 2009, p. 61). Significantly, it is integral in the provision of continuous care that nurses reassess the factors that may have contribute or led to DKA, and educate the patient and his family about strategies to prevent its recurrences (Smeltzer & Bare 2004 p. 1186; Lemone, Burke & Bauldoff 2011, p. 551).

acidic and basic so the functions of the body can work properly. Alkalosis is when the carbon dioxide level is decrease and bicarbonate level is increase in the body. Acidosis is when the carbon dioxide level is increase and bicarbonate level is decrease in the body.

The primary nursing diagnosis for this patient is impaired gas exchange, related to abnormal ventilation and perfusion ratio, as evidenced by restlessness, irritability, anxiety, decreased level of consciousness, abnormal arterial blood gases, and abnormal skin color (Gulanick & Myers, 2014, p. 82). A.C. has an endotracheal tube (ETT), and there is a note for the next day to have surgery to put in a tracheostomy. She is currently a smoker, her C02 is 74.6mEq/L which is high, her pH is low at 7.19, and the bicarbonate is 28.6mEq/L which is high. Her oxygen saturation is maintaining at 90%. Her PA02 is 56mm Hg and FI02 is 0.60. The patient is very anxious and restless in the bed, despite sedation and pain medication, and her skin is pale in color and she is diaphoretic.

Influenza, also known as “the flu,” is a virus that infects the respiratory tract. Although Influenza is not as severe as many viral infections it's almost the worst for viral infections of the respiratory tract. Typically, when someone is infected with influenza they experience fever (usually 100° to 103°F in adults, but even higher in children) and causes a cough, sore throat, runny or stuffy nose, and also headaches, muscle aches, and usually extreme tiredness. There are sometimes other symptoms such as nausea, vomiting and diarrhea but usually only in rare cases with young children. One other note: The term “Stomach flu” isn’t really caused by the influenza virus.

Did the pH level of the blood change at all during normal breathing? If so, how? The pH did not change during the normal breathing.

Acidosis is a condition in which there is an excessive acid condition of the body fluids or tissues, the body contains too much acid. There are many ways acidosis can occur. One way is when there is an extreme bicarbonate in the body. Bicarbonate is a chemical acting as a buffer, it keeps the blood’s pH from becoming too acid or to basic. Another way a body can become too acidic is there is a buildup of carbon dioxide in the blood. This can happen if you have breathing issues or poor lungs. Both the lungs and the kidneys can atone to a minor or major pH imbalances. The body’s pH level should be at a 7.40, acidosis is any pH at a 7.45 or higher. There are two different types of acidosis: respiratory and metabolic, both can be diagnosed using

Drug therapy consists of; Lasix, antihypertensives, antiemetics, H-2 blockers, erythropoietin, vitamins and electrolyte balancing agents (phosphate, calcium, V-D, Vit-B, and amino acids. Dialysis is mostly the patient’s only way of survival. Nutritional therapy is encouraging patients to avoid ↑Ca and ↑ protein foods. Fluid restriction is important since the kidneys have a difficult time excreting. If left untreated the patient would essentially die. The fluid overload combined with the toxicity of the left over wastes would shut down the body’s organs and death would occur.

Metabolic acidosis results from all conditions that decrease the pH of the body fluids below 7.35 and HCO3- levels are <22 mEq/L, with the exception of conditions resulting from altered function of the respiratory system. As hydrogen ions accumulate in the body fluids, buffers first resist a decline in pH. If the buffers cannot compensate for the increase in hydrogen ions, the respiratory center helps regulate the body fluid pH. The reduced pH stimulates the respiratory center, which causes hyperventilation. During hyperventilation, carbon dioxide is eliminated at a greater rate. The elimination of carbon dioxide also eliminates excess hydrogen ions and helps maintain the pH of the body fluids within a normal range. (Angus, 2006)

Acidosis is when the pH of one’s blood is below the normal level of 7.35. Alkalosis is when the pH of one’s blood is above 7.45. These can be broken down into two categories respiratory and metabolic. Normal oxygen (CO2) levels are 35-45 mmHg in systemic arterial blood. Normal levels for HCO3− 22-26mEq/liter in systemic arterial blood.