Acidosis and Alkalosis – What Nurses needs to know?

acidosis alkalosisWhenever you see a staff nurse exam question paper whether it be HAAD, DHA, MOH, Central govt exams, NCLEX – RN, CRNE etc minimum two questions from Acid – Base Balance or Acidosis – Alkalosis is a must. But this topic is not so difficult. We are trying here, to explain it in a simple way and easy to remember.If you like this, please do share this website with your friends.

Acidosis and Alkalosis for Competitive Staff Nurse Exams

Normal pH = 7.35 -7.45

Respiratory Alkalosis

– decreased PCo2 and Increased blood pH
– Causes – Hyperventilation, Hypoxia, fever, salicylate poison, ventillator prblms
– Signs – light headedness – why? (light headedness – If carbon dioxide levels are high, the body assumes that oxygen levels are low, and accordingly, the brain’s blood vessels dilate to assure sufficient blood flow and supply of oxygen. Conversely, low carbon dioxide levels (e.g. from hyperventilation) cause the brain’s blood vessels to constrict, resulting in reduced blood flow to the brain and lightheadedness.), inability to concentrate, convulsions, Chvosteks sign, muscle twitching
– Rx – Breathe into brown paper bag

Respiratory Acidosis

– Increased PCo2 and Decreased pH
– Causes – COPD, Lung trauma
– Signs – Increased PR and RR, BP, Fullness in head – Why? (fullness of head – due to increased blood flow to brain when PCO2 is increased.), dull head ache
– RX – IO chart and Fluid therapy, Positioning

Metabolic Alkalosis

– Excessive loss of Acid or Excessive gain of Bicarbonate
– Causes – vomiting, gastric suction, increased alkali intake
– Signs – tingling of fingers – why?, dizziness, confusion, shallow respirations
– Diagnosis – ABG – pH >7.45 and HCO3 > 26mEq/L, differential diagnosis between vomiting or diuretic ingestion or mineralocorticoid excess is by determining Urine Chlorine concentration.

Metabolic Acidosis

– Excessive absorption or retention fo acid or excessive excretion of HCO3
– causes – Ketoacidosis, Lactic acidosis, Prolonged fasting, Salycilate poisoning (causes respiratory    alkalosis too), oliguria, drains or  diarrhea
– signs – head ache, drowsiness, confusion, inreased RR, decreased CO
– Diagnosis – ABG – pH <7.35 and HCO3<22mEq/L, S.pottassium – Hyperkalemia – Why?

(Hyperkalemia in Metabolic acidosis is due to exchange of H+ ions with K+ ions and in Metabolic alkalosis vice versa)

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