Question

1. What are some of the signs and symptoms the may lead to an acidotic/alkalotic state.
2. What are the Stages and Phases of Acute Kidney Injury
3. What is Tonometry? Patient teaching for preventing increased IOP with or without surgery

Answer 1

1. ACIDOSIS AND ALKALOSIS

• Acidosis and alkalosis describe the abnormal conditions that result from an imbalance in the PH of the blood caused by an excess of acid or alkali. This imbalance is typically caused by some underlying condition or disease
• Normal blood PH must be maintained within a narrow range typically 7.35-7.45, to ensure the proper functioning of metabolic processes and the delivery of the right amount of oxygen to tissues.
• Acidosis refers to an excess of acid in the blood that causes the PH to fall below 7.35 and alkalosis refers to an excess of base in the blood that causes the PH to rise above 7.45
• Acidosis occurs due to increased acid or decreased base

1. Increased acid production within the body
2. Consumption of substances that are metabolized to acids
3. Decreased acid excretion
4. Increased excretion of base

• Alkalosis occurs due to decreased acid or increased base

1. Electrolyte disturbances caused by prolonged vomiting or severe dehydration
2. Administration or consumption of base
3. Hyperventilation

SIGNS AND SYMPTOMS

• Mild acidosis may not cause any symptoms or it may be associated with non specific symptoms such as fatigue, nausea, and vomiting.
• Acute metabolic acidosis may also cause an increased rate and depth of breathing, confusion, and headaches, and it can lead to seizures,coma,and in some cases death.
• Symptoms of alkalosis are often due to associated potassium(K+) loss and may include irritabilty, weakness and muscle and cramping.

STAGES AND PHASES OF ACUTE KIDNEY INJURY.

Acute kidney injury is defined as an abrupt reduction in kidney function based on an elevation in serum creatinine level, a reduction in urine output, the need for renal replacement therapy or acombination of these factors.

STAGES	CHANGE IN SERUM CREATININE LEVEL	URINE OUTPUT
STAGE 1	Increase > 0.3 mg/dl or 1.5 - to twofold from baseline	<0.5 ml/kglhour for more than 6 hours
STAGE 2	Increase > two- to threefold from baseline	<0.5 ml/kg/hour for more than 12 hours
STAGE 3	Increasev> threefold from baseline or > 4.0 mg per dl with an acute rise of atleast 0.5 mg per dl	<0.3 ml/kg/hour for 24 hours

TONOMETRY

Tonometry is a diagnostic test that measures the pressure inside the eyes, which is called intaocular pressure. This measurement helps to determine doctor the risk for glaucoma.

PATIENT TEACHING FOR INCREASED INTRAOCULAR PRESSURE

• Eat a healthy diet. Eating a healthy diet can help maintain the health.
• Exercise safely
• Limit caffeine
• Sip fluids frequently
• Sleep with your head elevated
• Take prescribed medicine