Lab Values
Normal pH value
7.35-7.45
The older adult has an impaired compensatory ability because of
decreased respiratory function
What imbalance is this
ph 7.58
paco2 35mm hg
pao2 75 mm hg
hco3- 50mEq./L
Metabolic Alkalosis no compensation
Alan is a 17 y/o/m who comes to the clinic with c/o feeling bad, fatigue, constant thirst, and frequent urination. Focused assessment reveals rapid deep respirations 28 with a fruity breath odor. A capillary glucose is 484mg/dl.
what type of imbalance do you expect?
what type of compensation breathing do you expect?
metabolic acidosis and kussmal respirations
Normal PaC02
35-45
Why does potassium rise during acidosis?
The body protects itself from the acidic state by moving hydrogen ions into the cells. Therefore potassium moves out to make room for hydrogen ions and the potassium level increases.
the nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which result validates the nurses findings?
a. ph 7.25 paco2 50
b. ph 7.35 paco2 40
c. ph 7.50 paco2 52
d. ph 7.52 paco2 28
a. ph 7.25 paco2 50
Mayna is an 18 y/o/f who presents to ED after a sexual assault. She is hysterical and is in severe emotional distress. Her BP is 140/96, HR 104, RR 38, O2 sat 96%, Lung sounds are clear.
what is the treatment
relieve her anxiety, slow breaths, c02 by mask, breathe into paper bag
Normal Pa02
80-100
Describe 3 mechanisms used to maintain pH?
Kidneys Lungs Buffers (Blood)
what imbalance is this
ph 7.28
paco2 28
pao2 70
hco3- 18
respiratory acidosis, partially compensated
anthony is a 54 y./o/m with a history of n/v for the past week. He has been self-medicating himself with baking soda to control his abdominal discomfort.
what type of acid base imbalance do yo expect
what is causing it
what compensation do you expect
metabolic acidosis
loss of gastric acid, excess bicarbonate with baking soda ingestion
limited compensation for metabolic alkalosis
Normal Hc03 (bicarbonate)
22-26 but your book list 23-30
Why does potassium drop during alkalosis?
The cells release hydrogen ions into the blood in an attempt to increase the acidity of the blood; this forces the potassium into the cells and potassium levels decrease.
what imbalance is this
ph 7.43
paco2 27
hco3- 19
respiratory alkalosis, fully compensated
anion gap helps determine what? and the normal value is?
sources of acidosis during metabolic acidosis and 8-12 mmol/L
Insulin is not only a regulator of glucose—it also stimulates the sodium–potassium ATPase pump, which moves potassium from the bloodstream into the intracellular space.
This lowers serum potassium (K⁺) levels, sometimes dramatically.
what imbalance is this
ph 7.60
paco2 30
pao2 60
hco3- 22
respiratory alkalosis, no compensation