25 Questions
What range of pH is considered acidic in human blood?
6.9 to 7.8
Which substance is used by the lungs to help maintain blood pH?
Carbonic acid
Which body organ is responsible for utilizing bicarbonate to regulate blood pH?
Kidneys
What pH range characterizes alkalosis in human blood?
7.45 to 7.8
Which laboratory evaluation is used to interpret acid–base balance in the body?
Arterial blood gas (ABG)
What is the expected range for the pH of human blood according to the text?
7.35 to 7.45
Which of the following is NOT a manifestation of respiratory acidosis?
Hyperventilation
Which of the following is a nursing intervention for a client experiencing respiratory alkalosis?
Monitoring respiratory rate
Which of the following is a cause of metabolic acidosis?
Diabetic ketoacidosis
Which of the following is NOT a manifestation of metabolic alkalosis?
Hyperventilation
Which of the following is a nursing intervention for a client experiencing metabolic acidosis?
Monitoring intake and output
Which of the following is a cause of respiratory alkalosis?
Anxiety
What is the primary role of the lungs in maintaining acid-base balance?
Excreting excess carbon dioxide from the body
Which of the following conditions is most likely to cause respiratory acidosis?
Chronic obstructive pulmonary disease (COPD) limiting airflow
In an acute episode of respiratory acidosis, how does the body attempt to restore acid-base balance?
By increasing the rate and depth of respirations to excrete more CO2
What is the relationship between pH and bicarbonate levels in metabolic acid-base disorders?
pH and bicarbonate levels change in the same direction
Which of the following is a cause of respiratory acidosis?
Central nervous system depression from trauma or sedatives
In chronic respiratory acidosis conditions, such as COPD, how does the body attempt to maintain acid-base balance?
By retaining bicarbonate to counteract the excess acidity
What is the primary role of the kidneys in metabolic acidosis?
To rid the body of excess acid
In respiratory alkalosis, what is the body's response?
The kidneys excrete bicarbonate through urine
Which of the following would be an appropriate nursing intervention for a client experiencing respiratory alkalosis caused by hyperventilation?
Offer a paper bag for the client to breathe into
Which of the following would be an appropriate nursing intervention for a client experiencing metabolic alkalosis?
Initiate seizure precautions and continuous cardiac monitoring
What is the primary role of the lungs in respiratory acidosis?
To retain more carbon dioxide
Which of the following client conditions would warrant obtaining arterial blood gases (ABGs)?
All of the above
How long does it typically take for the lungs and kidneys to respond to an acid-base imbalance, respectively?
Minutes to hours for the lungs, hours to days for the kidneys
Study Notes
Understanding Acid-Base Balance
- The body maintains a delicate balance between acidic and alkaline substances to maintain homeostasis.
- The pH level of the blood indicates the degree of acidity or alkalinity, with a normal range of 7.35 to 7.45.
Arterial Blood Gas (ABG) Analysis
- ABG analysis is used to interpret acid-base balance in the body.
- The results indicate whether there is an acid-base imbalance and its origin (respiratory or metabolic).
- ABG analysis includes:
- pH: acidity or alkalinity of the blood
- PaCO2: partial pressure of carbon dioxide (indicates respiratory component)
- HCO3–: bicarbonate level (indicates metabolic component)
Interpreting ABG Results
- Step 1: Look at the pH level (normal range: 7.35 to 7.45).
- Step 2: Look at the PaCO2 to determine the respiratory component (normal range: 35 to 45 mm Hg).
- Step 3: Look at the HCO3– to determine the metabolic component (normal range: 21 to 28 mEq/L).
Respiratory Acid-Base Imbalance
- Respiratory acidosis: high PaCO2, low pH (acidic environment).
- Causes: central nervous system depression, spinal cord injury, pulmonary diseases, functional disorders.
- Manifestations: anxiety, confusion, fatigue, shortness of breath, lethargy, sleepiness, tremors, flushed skin, sweating.
- Treatment: identify and treat underlying cause, supplemental oxygen administration, medications, and nursing interventions.
Respiratory Alkalosis
- Respiratory alkalosis: low PaCO2, high pH (alkaline environment).
- Causes: hyperventilation, pain, anxiety, severe stress, pregnancy, sepsis, infection, trauma, fever.
- Manifestations: lightheadedness, dizziness, confusion, chest discomfort, numbness in hands and feet.
- Treatment: decrease breathing rate, treat underlying cause, and nursing interventions.
Metabolic Acid-Base Imbalance
- Metabolic acidosis: low HCO3–, low pH (acidic environment).
- Causes: renal or hepatic failure, pancreatitis, dehydration, diabetic ketoacidosis, lactic acidosis, salicylate intoxication.
- Manifestations: long and deep breaths, confusion, headache, tachycardia, lethargy, loss of appetite, nausea/vomiting.
- Treatment: correct underlying cause, administer sodium bicarbonate, IV fluids, and nursing interventions.
Metabolic Alkalosis
- Metabolic alkalosis: high HCO3–, high pH (alkaline environment).
- Causes: prolonged vomiting, gastric suctioning, excessive use of diuretics or antacids, renal impairment, hypokalemia, hypovolemia.
- Manifestations: muscle twitching, lethargy, nausea, vomiting, tremors, numbness, lightheadedness, headache.
- Treatment: identify and correct underlying cause, and nursing interventions.
Nursing Interventions
- Monitor respiratory effort, lung sounds, and airway.
- Monitor vital signs, I&O, and subsequent ABG or lab results.
- Administer treatments as prescribed.
- Provide fall precautions and continuous cardiac monitoring.
- Prioritize client safety and address hypoxia.
Role of the Nurse
- Obtain and analyze ABG results.
- Identify potential problems and determine client's condition (e.g., acidosis vs. alkalosis, metabolic vs. respiratory).
- Implement interventions to address client's needs and cause of the problem.
- Develop goals tailored to the client's needs and evaluate the effectiveness of interventions.
Test your knowledge on the concept of blood pH levels, which indicates the acidity or alkalinity in the body. Learn about the pH scale and the impact of acidic and alkaline blood pH on health.
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