Problems
ABG results: pH 7.28, PaCO2 47 HCO3 24, what is the finding and what manifestations would you see
Uncompensated Respiratory Acidosis, hypoventilation due to chest trauma, sedation, overdose. can be acute or chronic: can be Asymptomatic
pH level, explain patho
7.35-7.45, pH is hydrogen atom, when the pH rises (alkalosis) the hydrogen atoms fall, when the pH falls (acidosis) the hydrogen atoms rise. the lungs (CO2) are what controls respiratory acidosis or alkalosis, the kidneys (HCO3) are what controls metabolic acidosis or alkalosis
Respiratory Acidosis S&S
hypoventilation
Acute: irritability, disorientation, headache
Chronic: Asymptomatic, headache
Metabolic Acidosis
monitor EKG and vitals
give sodium bicarb IV
draw serum electrolytes
Stage I
non-blanchable erythema, skin intact
ABG results: pH 7.32, PaCO2 40, HCO3 16. what is the finding of the ABG and manifestations
uncompensated metabolic acidosis, causes: abnormal bicarb loss, weakness fatigue, confusion N/V.
PaCO2 range, explain the patho
35-45, when the CO2 rises while breathing the pH begins to fall, when the CO2 starts to drop while breathing the pH begins to rise.
Respiratory Alkalosis S&S
hyperventilation
lightheadness
confusion
numbness, tingling
tetany
Metabolic Alkalosis
treat underlying cause
correct potassium level
in severe cases give ammonia chloride or hydrochloric acid
Stage 2
partial thickness skin loss
ABG result: pH 7.44, PaCO2 49, HCO3 28, what is the findings of the ABG, and manifestations
Fully compensated metabolic alkalosis, manifestations: not much manifestations because we have returned patients pH back to normal therefore any affects are from another cause most of the time.
HCO3 Values, explain patho
22-26, when the kidneys start excreting to much bicarb the bicarb levels start to decrease therefore causing the pH to fall and vice versa, when the kidneys retain to much bicarb everything starts to rise
Metabolic Acidosis S&S
weakness
fatigue
confusion
n/v
Respiratory Acidosis
Correct hypoventilation whether it is from to much sedation or overdose ie narcan
treat underlying cause
turn up or down O2
change ventilation settings
Stage 3
full thickness... bone, tendon, muscle are not exposed
ABG results: pH 7.5, PaCO2 50, HCO3 28, what are the findings of the ABG and manifestations
partially compensated metabolic alkalosis, manifestations: hypokalemia, excessive vomiting, hypotension
Partially compensated
When the values indicate that the body is compensating by all the ranges being out of the normal range, therefore if the patient is in metabolic acidosis, the CO2 will be in alkalosis.
Metabolic Alkalosis S&S
excessive vomitting
hypokalemia
hyperreflexia
hypotension
Respiratory Alkalosis
Paper bag
provide calm relaxing environment
pursed lip breathing
anxiety medications
Stage 4
full thickness skin loss, extensive damage to muscle, tendon, bone is exposed
ABG results: pH 7.48, PaCO2 31, HCO3 20 what are the findings of the ABG and what are manifestations
partial compensated respiratory alkalosis, manifestations: hyperventilation and anxiety
compensated or uncompensated
Uncompensated: when a person is in acidosis or alkalosis either metabolic or respiratory and the alternate level either HCO3 or CO2 remain within the normal range meaning the body is not trying to fix the problem
Compensated: when the pH has returned to normal!!
What are the two major organs that play a role in acid-base balance and why?
Kidneys play a role in metabolic because of Bicarb
Lung play a role in respiratory because of CO2
If your patient is in respiratory acidosis or alkalosis what is your biggest resource you can use, and what might they implement?
RT (respiratory therapy) and the may use a BiPAP or CPAP with orders :)
Unstageable
full thickness tissue loss, unable to completely identify due to slough or eschar