Question

1. Describe the pathophysiology related to acid-base imbalance.

2. What are the expected reference ranges for arterial blood gas values? PACO2 = HCO3 =

You already know that the ph of blood is 7.35-7.45

3. What possible medical conditions could cause the following acid-base imbalance conditions?

Provide an evidence-based rationale to support your response (example, something like this: Metabolic alkaloisis is seen in patients with ___________. This happens because the _____can't ____________ because of ____________ .)

○ Metabolic alkalosis

○ Metabolic acidosis

○ Respiratory alkalosis

○ Respiratory acidosis

4 For which potential complications (vital signs, symptoms, medication side effects) should the nurse monitor?

○ Metabolic alkalosis

○ Metabolic acidosis

○ Respiratory alkalosis

○ Respiratory acidosis

5. What teaching should be provided to the client who suffers from:

○ Metabolic alkalosis

○ Metabolic acidosis

○ Respiratory alkalosis

○ Respiratory acidosis

6. Identify a minimum of three nursing actions that should be included in a plan of care to address one of the above conditions (please state which one you are caring for). Provide an evidence-based rationale for each action.

Answer 1

1) A change in blood pH that leads to acidosis or alkalosis may be compensated.Compensation is the physiological response to an acid-base imbalance that attempts to normalise aterial blood pH.It may be either complete ,if pH indeed is brought within the normal range or parital ,if pH is still lower than 7.35.If the person has an altered pHdue to metabolic causes hyperventilation or hypoventilation can help bring blood pH back towards the normal range.Because it involves the respiratory system ,this form of compensation is termed as respiratory compensation.Respiratory compensation occurs within minutes and resches the maximum within hours.On the other hand,if a person has an alterd pH is due to respiratory causes renal mechanisms can help compenation for the alteration.This form of compensation is termed as metabolic compensation and it begin in minutes.

2) PACO2=35 -44 mmHg

HCO3=22-27mEq/L

3)a. Metabolic alkalosis:

Hyperaldosteroinsm,increase renal tubular reabsorption of sodium occurs with the resultant loss of hydrogen ions.

b. Metabolic acidosis:

Diabetic mellitus or diabetes ketoacidosis:An insufficent supply of insulin causes increase fat metabolism leading to an excess accumulation of ketones or other acids the bicarbonate endsup being depleted

c.Respiratory alkalosis:

Fever:Causes increase metabolism ,resulting in overstimulation of the respiratory system.

d. Respiratory acidosis:

Asthma:Spasms resulting from allergies ,irritants,or emotions cause the smooth muscles of the bronchioles to constrict,resulting in ineffective gas exchange.

4) Potential complications of:

a. Metabolic acidosis:Renal failure ,fracture due to osteoporosis,muscle weakness,,decreased cardiac output causes hypotension.

b.Metabolic alkalosis:Disorientation,seizure,coma.

c.Respiratory alkalosis:Chest pain,dizziness,muscle spasm,anxiety.

dRespiratory acidosis:Decresaed heart functioning,arrhythmias,hypotension.

5) a. Metabolic alkalosis:

It is a deficit of carbonic acid and decrease in hydrogen ion concentration.

Instruct the client to take salt in the diet.

If any signs of respiratory distress occur inform the hcp immediately.

b.Metabolic acidosis:A total concentation of buffer base that is loer than normal,with a relative increase in the hydrogen ion concentration.

Patient eucation:Instruct the client to take a diet low in protein and high in calories.

Ask them to take insulin in dabetes mellitus .

c.Respiratory alkalosis:

Encourage client to do breathing patterns.

Instruct the client about voluntary holding of the breath if appropriate.

Assist with breathing techniques.

d.Respiratory Acidosis:

Respiratory acidosis caused by lung disease that affects lungs aability to function normally.So educate the patients regarding ways to improve lung health like avoid smoking.Other teaching include monitor healthy weight nd causcious use of sedatives.Also ask medical attention if situation worsens.