Question

Overview of Acid/Base Imbalance: Buffer Systems and Methods to Regulate pH.

Describe a patient that you would suspect has an acid/base imbalance including possible history, signs, and symptoms (you get to "invent" this patient!)

1. State what you would report to the RN
2. State what Doctor's orders you might anticipate

Answer 1

Acid and base in the body is required to maintain the normal balance or homeostasis of the blood.It can be classified either into acidosis (decreased pH) or alkalosis (increased pH) The chief indicators in very minute is predicted along with the PaCO2 and the HCO3 (bicarbonate) levels.With the help of this it can be broadly divided in to metabolic or respiratory namely

• Metabolic (acidosis or
• alkalosis)
• Respiratory (acidosis or alkalosis )
• Buffer system is one of the mechanism which can regulate the altered pH levels .This regulates with the help of proteins, phosphate and carbonic acid.

The renal system and the respiratory system also acts in the acid base  balance.

Metabolic acidosis can be commonly found in patient .

Here the pH level is decreased.This can be because of renal function impairment, when there is severe loss of the bicarbonate levels in the blood with raised serum pH, uncontrolled diabetes.

The chief signs and symptoms of it are

• GIT:nausea,vomiting ,pain in abdomen
• CNS:headache,seizure ,coma
• CVS:palpitations, hypotension, tachycardia
• Respiratory:Kussmaul breath, decreased oxygen levels
• Musculoskeletal:Pain

The above signs and symptoms has to be reported to the nurse with patients vitals ,saturation

The order which can be expected are

• Sodium bicarbonate administration intravenously
• Bronchodilators in case of shortness of breath
• Oxygen administration
• Administration of koop diuretics
• Antacids to prevent gastrointestinal complaints
• Electrolyte v iui a IV fluids to prevent electrolyte imbalance
• Potassium citrate or sodium citrate