Acid-Base Imbalances PDF

ACID-BASE IMBALANCES DR ALHASSAN SIBDOW SENIOR LECTURER NURSING, HOD NURSING WISCONSIN SCHOOL OF NURSING & MIDWIFERY Email: [email protected] BASICS OF ACID-BASE WATER IS ESSENTIAL SOURCE OF ACID AND BASE 1. WATER = FLUIDS = H20 2. OXYGEN = O2 = LOW LEVELS MEANS ACID...

ACID-BASE IMBALANCES DR ALHASSAN SIBDOW SENIOR LECTURER NURSING, HOD NURSING WISCONSIN SCHOOL OF NURSING & MIDWIFERY Email: [email protected] BASICS OF ACID-BASE WATER IS ESSENTIAL SOURCE OF ACID AND BASE 1. WATER = FLUIDS = H20 2. OXYGEN = O2 = LOW LEVELS MEANS ACID 3. CARBONDIOXIDE = C02 = DIRECTLY PROTIONAL TO ACID INCRESASES 4. ELCTROLYTES = K+, Na+, Ca2+ 5. FOOD = GLUCOSE BASIC H20= H+ + OH- H+ = ACID; OH- = BASE pH= Power (conc.) of hydrogen ion (NORMAL pH = 7.35 – 7.45) ACID = SOLN. WITH HIGH HYDROGEN ION CONC.= LOW pH = ACIDOSIS=pH7.45 NB: ANY CHANGES IN HOMEOSTASIS (FLUID, RESPIRATION, GIT, )= ACID-BASE IMBALANCE BASIC 1. AIRWAY = OBSTRUCTION= HYPOVENTILATION= INCREASE CO2= INCREASE IN ACID = ACIDOSIS 2. BREATHING= HYPOVENTILATION (CO2 RETENTION); HYPERVENTITION (REMOVES CO2= ALKALOSIS) 3. CIRCULATION= HYPOVOLEMIA (DEHYDRATION)= ACIDOSIS; HYPERVOLEMIA (OVERHYDRATION) ALKALOSIS 4. NUTRITION = UPPER GIT (ACID =HCL) = VOMITING= METABOLIC ALKALOSIS; LOWER GIT (BASE = KOH)= DIARRHOEA = METABOLIC ACIDOSIS 5. RENAL (BICARBONATE; LOW= ACIDOSIS; HIGH= ALKALOSIS) = OLIGURIA (ACIDOSIS); POLYURIA (ALKALOSIS) ABGs 1. pH = 7.35 – 7.45= ACIDOSIS7.45 2. PaCO2 = 35 – 45= RESPIRATORY 3. PaO2 = 80 -100 4. SPO2= 95-100 5. HCO3- = 22 – 26 = METABOLIC ACID-BASE EQUATION 1. H20 + CO2 = H2CO3 = HCO3- + H+ = HOMEOSTASIS 2. H20 + CO2 = H2CO3 = RESPIRATORY 3. H2CO3 = HCO3- + H+ = METABOLIC CAUSES 4. RESPIRATORY DISORDER= RESPIRATORY ACIDOSIS/ALKALOSIS = CO2 A. HYPOVENTILATION= CO2>45(ACIDOSIS); B. HYPERVENTION= CO245 (HYPERCAPNIA); HYPOXIASPO2 HIGH 3. METABOLIC ACIDOSIS = LOW pH = LOW BICARBONATE = DIARRHOEA 4. METABOLIC ALKALOSIS = HIGH pH = HIGH BICARBONATE = VOMITING 5. MIXED ACID-BASE IMBALANCE ACID-BASE CONTROL 1. CHEMICAL BUFFER: controls hydrogen ions in the blood= blood 2. RESPIRATORY BUFFER: carbon dioxide ions in the blood= lungs 3. RENAL BUFFER: Bicarbonate ions in the urine= kidney ABGs interpretation Arterial Blood Gases = ABGs pH/CO2/HCO3 EX. ABG = 7.32/50/25; pH45= Respiratory; HCO3= Normal; therefore the patient RESPIRATORY ACIDOSIS EX. 2 ABG = 7.55/43/32; pH>7.45= Alkalosis; CO2=Normal; HCO3=High; Metabolic Alkalosis BASIC RULES OF ACID-BASE IMBALANCES 1. When pH increases (alkalosis) every vital organ (brain, heart, lungs, kidneys, liver, pancreas) function increases, except for potassium conc. = hypokalemia a. brain= hyperreflexia, seizures b. Heart= tachycardia, hypertension, palpitations c. Lungs = tachypnea, hyperventilation, d. Kidneys = polyuria e. Liver = increase metabolic rate = diaphoresis, hyperthermia f. Pancreas = increase insulin = hypoglycemia BASIC RULES OF ACID-BASE IMBALANCES 2. When pH decreases (acidosis) every vital organ (brain, heart, lungs, kidneys, liver, pancreas) function decreases, except for potassium conc. = hyperkalemia a. brain= confusion, disorientation, decrease LOC b. Heart= bradycardia, hypotension, cold clammy skin c. Lungs =bradyspnea, hypoventilation, d. Kidneys = oliguria (