PowerPoint Acid/Base, Slides of Nursing

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ACID BASE

BALANCE

INTERPRETIN G ARTERIAL BLOOD GAS Review the pH result. Acidosis or alkalosis? Review the PaCO₂ result. Acidosis or alkalosis? Review the HCO₃ − result. Acidosis or alkalosis?

INTERPRETIN G ARTERIAL BLOOD GAS: COMPENSATI ON

Match either the PaCO₂ or

HCO₃−^ result with the pH

result to determine the cause

of the acid-base imbalance.

Does either the PaCO₂ or

HCO₃

−

go in the opposite

direction of the pH? This

result indicates compensation

by that system.

Review the PaO₂ and SaO₂

results. If they are below

normal limits, the patient is

hypoxic.

ACID-BASE DISORDER S: RESPIRATO RY ACIDOSIS Altered ventilation CO₂ retention pH <7. PaCO₂ > When compensated, HCO₃

ACID-BASE DISORDERS: RESPIRATORY ACIDOSIS

• (^) Nursing interventions
  • (^) Maintain airway
  • (^) Monitor ABG
  • (^) Monitor vital signs
  • (^) Administer supplemental oxygen
  • (^) Assist with intubation
  • (^) Monitor potassium levels

ACID-BASE DISORDERS: RESPIRATORY ALKALOSIS

• (^) Treatment
  • (^) Identify and eliminate causative agent
  • (^) Reduce fever
  • (^) Eliminate source of sepsis
  • (^) Oxygen therapy
  • (^) Sedative or anxiolytic therapy
  • (^) Diuretics

ACID-BASE DISORDERS: RESPIRATORY ALKALOSIS

• (^) Nursing interventions
  • (^) Encourage slow, deep breathing
  • (^) Monitor vital signs
  • (^) Provide emotional support and reassurance
  • (^) Assist with activities of daily living

ACID-BASE DISORDERS: METABOLIC ACIDOSIS

• (^) Causes:
  • (^) Nonvolatile acids
    • (^) Ketoacidosis, lactic acidosis
  • (^) Loss of alkali through GI tract
    • (^) Diarrhea, malabsorption
  • (^) Decreased acid excretion in acute or chronic renal failure
• (^) pH <7.
• (^) HCO₃−^ <
• (^) If compensated, PaCO₂ <

ACID-BASE DISORDERS: METABOLIC ACIDOSIS

• (^) Treatment
  • (^) Treat underlying cause
  • (^) Sodium bicarbonate replacement
  • (^) Parenteral fluid replacement
  • (^) Rapid-acting insulin
  • (^) Antidiarrheals
  • (^) Dialysis
  • (^) Mechanical ventilation

ACID-BASE DISORDERS: METABOLIC ACIDOSIS

• (^) Nursing interventions
  • (^) Monitor hemodynamic status
  • (^) Assess peripheral vascular status
  • (^) Administer sodium bicarbonate as ordered
  • (^) Provide reassurance and teaching