Acid Base
What are three main components of ABG
PaCO2 (Carbon dioxide), pH Balance, HCO3 (Bicarbonate)
What causes respiratory alkalosis and the treatments?
Anxiety with hyperventilation, overactive thyroid, fever, ASA poisoning
Brown paper bag breathing*, monitor electrolytes,
If the pH is normal what is the imbalance?
Full Compensation
What are four functions of the liver
Metabolizes glucose, proteins and fats
Stores Vitamins (A,D,E.K)
Forms and excretes bile
Synthesizes clotting factors
What is biliary colic?
When a gallstone obstructs the cystic duct- gallbladder becomes inflamed.
PaCO2 - 35 to 45
HCO3 - 22 to 26
What are 5 risk factors for electrolyte/fluid imbalance?
Advanced Age, Pts receiving tube feeding, diuretic usage, Diabetes insipidus, burns
If the pH is abnormal and both PaCO2 and HCO3 are abnormal what is the imbalance
Partial Compensation
What is Cirrhosis, and the S/S + Management
Irreversible scarring of the liver
Jaundice, Ascites, Varices, Clay Colored Stool
Management: Sodium restriction, K+ sparring diuretics (SPIRONOLACTONE), avoid alcohol
What is bile composed of?
Water, Electrolytes, Fatty Acids, Cholesterol, and Bile Salts
What causes metabolic alkalosis, and what are the treatments?
Antacids (bicarb), diuretics, vomiting, gastric suctioning.
Administer/Monitor Ca and K+ levels, Antiemetics, IV Sodium Chloride NS (Hypotonic Solution)
Respiratory System diagnoses that can cause an imbalance
COPD, Pneumonia, Asthma
If the pH is abnormal and only one of the other values are abnormal what is the imbalance?
What is hepatic encephalopathy?
S/S confusion, disorientation, seizures, motor disturbances and insomnia/restlessness.
Caring for someone with a biliary stent or drain
keep below abdomen, empty at 2/3 full, record output and monitor patency (never clamp)
What causes metabolic acidosis and the treatment?
Shock, Cardiac Arrest, DKA, ASA overdose
Replacing fluids/electrolytes, IV Bicarb for severe cases, Monitor K+ levels.
Metabolic related diagnoses that can contribute to imbalance
Diabetes, Kidney disease, diarrhea, vomiting
Because the pH is further from normal
What is Hepatitis
Liver inflammation after exposures to drugs or chemicals, alcohol abuse or infection
what will LFTs look like in someone with liver failure/cirrhosis
elevated ALT, AST, Bilirubin and PT/INR decreased albumin
What causes respiratory acidosis and the treatment?
emphysema/COPD, pneumonia, drug overdose
mechanical ventilation*, airway suction, bronchodilators, IV sodium Bicarb, monitor HR and cardiac rhythm
Smoking, High Protein, Poor Hydration, Medications
Why do you see fewer symptoms when compensation is present?
pH is closer to normal
What are the three phases of hepatitis?
Pre-icteric: asymptomatic
Icteric: Jaundice, clay-colored stool, dark urine
Post-icteric: Liver enlargement, malaise, fatigue.
What labs would be abnormal in someone with Pancreatitis?
Increased Amylase and Lipase