Acid Base Imbalance 01

ACID – BASE
BALANCE AND
IMBALANCE
PRESENTED BY
ASHOK
1ST YEAR MSC NURSING
GOVERNMENT COLLEGE OF
NURSING
GIMS CAMPUS KALABURGI
BUFFER SYSTEM
A buffer system is a solution that resists change in pH
when acids or bases are added to it.
THREE MAJOR MECHANISMS ARE USED :

01.CELLULAR BUFFER
02.THE LUNGS
03.THE KIDNEY
RESPIRATOR
Y ACIDOSIS
Contents
 Definition
 Risk Factors
 Causes
 Signs and Symptoms
 Pathophysiology
 Diagnostic Tests
 Treatment
 Nursing Interventions
 Prevention
What is Respiratory Acidosis?
Respiratory acidosis is a condition that occurs when the
lungs can’t remove enough of the carbon dioxide (CO2)
produced by the body.
Excess CO2 causes the pH of blood and other bodily fluids to

decrease, making them too acidic. Normally, the body is able
to balance the ions that control acidity.
This balance is measured on a pH scale from 0 to 14. Acidosis

occurs when the pH of the blood falls below 7.35.
(normal blood pH is between 7.35 and 7.45)
Types of Respiratory Acidosis
There are two types of respiratory acidosis:
1.Acute respiratory acidosis the PaCO2 is elevated above

the upper limit of the reference range (ie, >45 mm Hg) with
an accompanying acidemia (ie, pH < 7.35. Occurs when an
abrupt failure of ventilation occurs.
2.Chronic respiratory acidosis the PaCO2 is elevated above

the upper limit of the reference range, with a normal pH
(7.35-7.45) or near-normal secondary to renal compensation
and an elevated serum bicarbonate levels (ie, >30 mEq/L).
Risk Factors
 Chronic Obstructive Pulmonary Disease

 Asthma
 Sleep apnea
 Pneumonia
 Stroke
 Obesity
Causes
 Chronic obstructive respiratory
disorders: emphysema, chronic
bronchitis
 Chest wall trauma
 Pulmonary edema
 Atelectasis
 Pneumothorax
 Drug Overdose
 Pneumonia
 Guillain-Barre syndrome
Signs and Symptoms
 CNS disturbances:
restlessness, confusion, and
apprehension to somnolence
with fine flapping tremor, or
coma.
 Headache
 Dyspnea
 Tachypnea
 Decrease in blood pressure
 Mental cloudiness and
feeling of fullness in head
 Weakness
Pathophysiology
Non-modifiable Modifiable
-Gender - Lung Disorders

-Heredity -Sleep Disordered Breathing
-Age -Overdose of Drugs
-Diseases of the
nerves/muscles of the chest
Hypoventilation
Excess CO2 production
Decreased pH level (<7.35)
Increased PaCO2 level (>44mmHg)

Diagnostic Tests
 Blood gas measurement
Blood gas is a series of tests used to measure
oxygen and CO2 in the blood. A healthcare
provider will take a sample of blood from your
artery. High levels of CO2 can indicate acidosis.
 Electrolytes
Electrolyte testing is a group of tests that measure
levels of Na+ (sodium), K+ (potassium), Cl-
(chloride), and bicarbonate. One or more of the
electrolytes will be increased or decreased in
people with acid-base disorders such as
respiratory acidosis.
 Lung function tests
Spirometry is the most common lung function
test. It measures how much and how quickly you
can move air out of your lungs. Many people with
this condition have reduced lung function.
Continuation…
 Chest X-ray
X-rays can help doctors see injuries or other problems likely to cause
acidosis.
 Other tests
Based on these tests, your doctor may also perform other tests to help
diagnose the underlying condition that’s causing the acidosis. (Another
condition, known as metabolic acidosis, may cause similar symptoms,
and the doctor may order tests to be sure the problem is solely
respiratory. These tests measure the amount of acid in your body,
which may be caused by kidney failure, diabetes, or other conditions,
and include glucose, lactate, and ketones.) Other tests include drug
testing, a complete blood count (CBC), and a urinalysis (urine test).
Treatment
 Bronchodilators: such as beta agonists (eg, albuterol and
salmeterol), anticholinergic agents (eg, ipratropium bromide and
tiotropium), and methylxanthines (eg, theophylline) are helpful
in treating patients with obstructive airway disease and severe
bronchospasm. Theophylline may improve diaphragm muscle
contractility and may stimulate the respiratory center.
 Oxygen Therapy - Oxygen therapy is employed to prevent the

sequela of long-standing hypoxemia.
Patients with COPD who meet the criteria for oxygen therapy
have been shown to have decreased mortality when treated
with continuous oxygen therapy.
Continuation…
 Ventilatory Support – Therapeutic measures that may be
lifesaving in severe hypercapnia and respiratory acidosis
include endotracheal intubation with mechanical ventilation
(invasive) and noninvasive positive pressure ventilation
(NIPPV) delivered through a non invasive interface(face
mask, nasal mask or nasal plugs) techniques such as
Continuous positive-airway pressure ventilation (CPAP) and
Bi-level positive airway pressure ventilation (BPAP)
Endotracheal Intubation w/ Mechanical Non invasive positive pressure ventilation
Ventilation (NIPPV)
Nursing Interventions
 Remain alert for critical changes in patient’s respiratory, CNS
and cardiovascular functions. Report such changes as well as
any variations in ABG values or electrolyte status
immediately.
 Maintain adequate hydration.
 Maintain patent airway and provide humidification if acidosis
requires mechanical ventilation. Perform tracheal suctioning
frequently and vigorous chest physiotherapy, if ordered.
 Institute safety measures and assist patient with positioning.
 Continuously monitor arterial blood gases.
Prevention
 Do not smoke. Smoking leads to the development of many
severe lung diseases that can cause respiratory acidosis.
 Losing weight may help prevent respiratory acidosis due to

obesity (obesity-hypoventilation syndrome).
 Be careful about taking sedating medicines, and never

combine these medicines with alcohol.
 Use your CPAP device regularly if it's been prescribed for you
RESPIRATORY
ALKALOSIS
hazel
What is Respiratory Alkalosis
Respiratory alkalosis as a condition

characterized by decreased partial pressure of
carbon dioxide (PCO2) in the blood due to
hyperventilation, leading to an increase in blood
pH.
Causes of Respiratory Alkalosis
01.Hyperventilation due to anxiety
02.Fever
03.Pain
04.hypoxemia or as a compensatory mechanism in
metabolic acidosis.
Pathophysiology
Hyperventilation leads to decreased PCO2 levels in
the blood.
Resulting in respiratory alkalosis. Include details on
the role of the respiratory system in maintaining acid-
base balance.
Sign and symptoms
01.Dizziness
02.Lightheadedness
03.Tingling sensations
04.Syncope
05.Muscle spasms
Diagnosis: Discuss the diagnostic criteria for
respiratory alkalosis, which typically include arterial
blood gas analysis showing decreased PCO2 (<35
mmHg) and increased pH (>7.45).
Treatment: Outline the management of respiratory
alkalosis, which focuses on addressing the underlying
cause. This may involve treating anxiety or pain,
providing supplemental oxygen, or correcting
metabolic abnormalities.
Complications: Highlight potential complications of
respiratory alkalosis, such as arrhythmias, decreased
cerebral blood flow, and electrolyte imbalances.
METABOLIC
ACIDOSIS
Metabolic acidosis is an acid- base disorder
characterized by excess or too much acid (low pH) in
the body fluids or when the kidneys are not removing
enough acid from the body and deficient bicarbonate
concentration caused by an underlying non-
respiratory Disorder.
Causes and Risk factors
01.Diabetic ketoacidosis
02.Hyperchloremic acidosis
03.Kidney disease
04.Severe Dehydration
05.Hypoaldosteronism
06.Lactic acidosis due to alcohol, cancer,liver failure,
Hypoglycemia and seizures.
Clinical manifestations
01.Fatigue
02.Headache
03.Drowsiness
04.Increased RR
05.Vomiting and Nausea
Diagnostic evaluation
01.ABG
02.CBC
03.ECG Will detect dysrhythmias caused by
increased Potassium.
04.Elevation of ketones indicate diabetic , alcoholic ,
and starvation ketoacidosis.
METABOLIC
ALKALOSIS
Definition of Metabolic Alkalosis
Metabolic Alkalosis is characterized by a primary rise
in the plasm bicarbonate concentration and high pH
With or without compensatory increase in PaCo2.

Acid Base Imbalance 01

Uploaded by

Copyright:

Available Formats

Acid Base Imbalance 01

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Acid Base Imbalance 01

Uploaded by

Copyright:

Available Formats

ACID – BASE

THREE MAJOR MECHANISMS ARE USED :

Excess CO2 causes the pH of blood and other bodily fluids to

This balance is measured on a pH scale from 0 to 14. Acidosis

1.Acute respiratory acidosis the PaCO2 is elevated above

2.Chronic respiratory acidosis the PaCO2 is elevated above

 Chronic Obstructive Pulmonary Disease

-Gender - Lung Disorders

Excess CO2 production

Decreased pH level (<7.35)

Increased PaCO2 level (>44mmHg)

 Oxygen Therapy - Oxygen therapy is employed to prevent the

 Losing weight may help prevent respiratory acidosis due to

 Be careful about taking sedating medicines, and never

Respiratory alkalosis as a condition

You might also like