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Acid Base Handout Revised

This document discusses acid-base imbalances and normal blood gas values. It provides information on the four main acid-base imbalances: metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis. For each imbalance it describes the expected pH, HCO3, and PCO2 levels as well as typical compensation mechanisms and common causes like diabetes, kidney failure, vomiting, and hypoventilation. It also provides examples of blood gas readings and challenges the reader to identify the acid-base imbalance in each case. Key points emphasized are starting with the pH to determine if it is normal, acid, or alkaline and then looking at CO2 or HCO3 levels to determine if the problem is

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Karen Hutchinson
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120 views3 pages

Acid Base Handout Revised

This document discusses acid-base imbalances and normal blood gas values. It provides information on the four main acid-base imbalances: metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis. For each imbalance it describes the expected pH, HCO3, and PCO2 levels as well as typical compensation mechanisms and common causes like diabetes, kidney failure, vomiting, and hypoventilation. It also provides examples of blood gas readings and challenges the reader to identify the acid-base imbalance in each case. Key points emphasized are starting with the pH to determine if it is normal, acid, or alkaline and then looking at CO2 or HCO3 levels to determine if the problem is

Uploaded by

Karen Hutchinson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Acid – Base Imbalances

Normal blood gases:


PH 7.35 – 7.45
PO2 80 – 100 mm Hg
PCO2 35 – 45 mm Hg
HCO3 22 – 26 mmol/ L
SaO2 > 95%

State PH HCO3 PCO2 Compensation


Metabolic Lungs blow off CO2
Acidosis
Metabolic Lungs hold onto CO2; Kidneys hold
Alkalosis hydrogen and dump HCO3
Respiratory Kidneys hold on to HCO3 and get rid of
Acidosis hydrogen
Respiratory Kidneys get rid of HCO3 and hold onto
Alkalosis hydrogen

Causes of Acid-Base Imbalances

State Cause Signs and Symptoms


Metabolic Acidosis ASA overdose, renal Drowsiness, confusion,
failure, diarrhea, sepsis, increase respiratory rate,
Ph < 7.35; HCO3 < 22 diabetic acidosis N/V, headache
Metabolic Alkalosis Vomiting, excessive Stiff muscles, tingling
antacids, GI suctioning, low extremities, dizziness,
Ph > 7.45; HCO3 > 26 potassium, high calcium Kussmaul’s respirations
Respiratory Acidosis CNS depression, Increasing BP, P, and RR
hypoventilation, airway Dysrhythmias, restlessness,
Ph < 7.35; PCO2 > 45 obstruction, pneumonia, confusion, weakness
aspiration, drug overdose,
pulmonary edema,
respiratory depression
Respiratory Alkalosis Anxiety, hyperventilation, Light-headedness, inability
Pulmonary embolism, to concentrate, confusion,
Ph > 7.45; PCO2 < 35 hypoxia numbness/tingling

Helpful hints for interpreting ABGs


 Always start with the ph
 Determine if the ph is normal, acid or alkaline
 Look at other values to see which one could cause the ph
o If the CO2 value is consistent with, agrees with, or matches the ph, the problem
is respiratory
o If the HCO3 value is consistent with, agrees with, or matches the pH, the
problem is metabolic
Examples:

PH 7.32
PCO2 58 _________________________
HCO3 32
PO2 60

Ph 7.51
PCO2 30
HCO3 22 _________________________
PO2 80-100

Ph 7.35
PCO2 30
HCO3 16 __________________________
PO2 80-100

Ph 7.52
PCO2 52
HCO3 34 __________________________
PO2 80-100

Challenge:

1. An adult is admitted to the hospital after several days of vomiting. Her breathing is
shallow and slow. What acid-base imbalance do you expect?

2. The nurse reviews a client’s ABG results which are as follows: pH is 7.6; PCO2 is
37, and HCO3 is 32. Which acid-base balance is this client experiencing?

3. The nurse reviews the ABG results for a client with COPD. The ph is 7.3; PCO2
is 56; and HCO3 is 24. Which acid-balance is the client experiencing?

4. A client’s ABG reveals the following values: pH 7.2; HCO3 22; PaCO2 40. What
illness does this indicate?

5. A client’s ABGs reveal the following values: Ph 7.8; HCO3 26; and PaCO2 28.
Which illness does this indicate?

6. A client’s ABG reveals the following: pH 7.0; HCO3 24; and PaCO2 56. What
illness does this indicate?

7. The nurse knows that respiratory acidosis occurs in:


a. Diuretic therapy
b. Hypoxia
c. Oversedation
d. Potassium deficit

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