Which Acid-Base Disorder?
The nurse is caring for a patient with a nasogastric tube that is attached to low suction. The nurse monitors the patient, knowing that the patient is at risk for which acid-base disorder?
Metabolic alkalosis
Loss of gastric fluid via nasogastric suction or vomiting causes metabolic alkalosis as a result of the loss of hydrochloric acid.
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.
pH 7.49, pCO2 41 mm HG, HCO3- 38 mmol/L Is the patient compensating? Metabolic alkalosis or acidosis?
Uncompensated metabolic alkalosis because an increase in pH, & an increase in HCO3, & PCO2 is normal
The nurse caring for a patient with an ileostomy understands that the patient is most at risk for developing which acid-base disorder?
Metabolic acidosis
Intestinal secretions are high in bicarbonate and may be lost through enteric drainage tubes, an ileostomy, or diarrhea.
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.
A patient with a 3-day hx of nausea/vomiting is hypoventilating & has a RR of 10.
The nurse expects the patient's pH to be increased or decreased?
Increased
Patients experiencing n/v would most likely present with metabolic alkalosis resulting from loss of gastric acid, thus causing the pH & HCO3- to increase. Symptoms experienced by the patient would include hypoventilation & tachycardia.
Which of the following is a NOT cause of metabolic acidosis?
1. Opioid overdose
2. Ileostomy
3. Patient with ESRD refusing HD treatment
4. Patient being admitted with DKA
Opioid overdose... which imbalance is this patient at risk for?
What is the normal serum potassium level?
3.5-5.0 mEq/L
A patient who is found unresponsive has ABGs drawn and the results indicate the following: pH is 7.12, PCO2 is 90 mm Hg, and is HCO3- 22 mEq/L. The nurse interprets the results as indicating which condition?
1. Metabolic acidosis with compensation
2. Respiratory acidosis with compensation
3. Metabolic acidosis without compensation
4. Respiratory acidosis without compensation
4. Respiratory acidosis without compensation
Because the bicarbonate is still within normal limits, the kidneys have not had time to adjust for this acid-base disturbance.
The nurse plans care for a patient with COPD, understanding that the patient is most likely to experience what type of acid-base imbalance?
Respiratory acidosis is most often caused by hypoventilation in a client with COPD.
COPD is a respiratory condition, not a metabolic one.
Describe 3 mechanisms used to maintain pH?
Kidneys Lungs & Chemical Buffers
The nurse is caring for a patient who is on a mechanical ventilator. ABG results indicate a pH of 7.50 & a PCO2 of 30 mmHg. The nurse has determined that the patient is experiencing respiratory alkalosis. Which would you expect the patient's potassium level to be?
Potassium level under 3.5 mEq/L
A patient is experiencing a severe asthma attack, which acid-base imbalance is the patient most at risk for?
Respiratory Acidosis
Which acid-base balance systems is the fastest.
Buffers
In Respiratory Acidosis: pH is__ (high or low), PaCO2 is ___ (high or low), HCO3 is ___ (high or low)
In Respiratory Acidosis: pH is low, PaCO2 is high, HCO3 is high