Determine The Acid Base Imbalance

Front 1

ph 7.20
pCO2 68
HCO3- 26

Back 1

respiratory acidosis

Front 2

pH 7.60
pCO2 38
HCO3 37

Back 2

metabolic alkalosis

Front 3

pH 6.9
pCO2 88
HCO3 33

Back 3

Uncompensated Respiratory Acidosis

Front 4

pH 7.01

Back 4

acidosis

Front 5

pH 7.48

Back 5

alkalosis

Front 6

pH 7.33
pCO2 35
HCO3 20

Back 6

Metabolic alkalosis

Front 7

Causes for Metabolic Alkalosis

Back 7

Prolonged NGT suction
Excessive vomiting
Loss of a fixed acid

Front 8

Causes for Metabolic Acidosis

Back 8

Diarrhea
Diuretics
Loss of a fixed base

Front 9

Causes for Respiratory Acidosis

Back 9

Hypoxia
Cardiac Arrest
Ineffective respiration leading to carbon dioxide trapping
Asthma/Pneumonia

Front 10

Causes for Respiratory Alkalosis

Back 10

Hyperventilation- Ventilator
Neurological damage- decrease in respirations.
Pain, labor

Front 11

Treatment for the following acid base imbalance:

pH 7.21, pCO2 58, HCO3 24

Back 11

This is respiratory acidosis.
Treatment is administration of oxygen
Identification of disorder and treatment

Front 12

Treatment for the following acid base imbalance:

pH 7.48, pCO2 28, HCO3 23

Back 12

This is respiratory alkalosis
Treatment is identification of cause and have patient breathe into a paper bag, decrease rate of breathing on a ventilator, administer anxiolytics/morphine.

Front 13

Which type of acid base imbalance would you expect to see in the following patient type? A 26 year old female patient with a severe case of Chron's disease?
What nursing interventions are necessary at this time.

Back 13

Metabolic acidosis
This patient would need fluid administration and correction of electrolyte imbalance.
If there is a code situation, administration of sodium bicarb may also be needed. The only time that sodium bicarb is administered is for a documented case of Metabolic acidosis.

Front 14

Which type of acid base imbalance would you expect to see in the following patient type?
A 68 year old man with dyspepsia that he treats with bicarbonate of soda?
What nursing interventions are necessary at this time?

Back 14

Metabolic alkalosis
The patient would need fluid therapy with replacement of electrolytes. Education would also be needed as to appropriate treatment of dyspepsia and further studies to identify the cause of his pain.

Front 15

Which type of acid base imbalance would you expect to see in the following patient type:
A 28 year old man who has prolonged NGT suction due to a perforated esophagus?
What nursing interventions are necessary at this time?

Back 15

Metabolic alkalosis
Treatment would be to accurately measure the NGT secretions and discuss with the physician the possibility of replacement of losses. The NGT needs to be confirmed for position and there may be need to slow the suctioning of secretions. Electrolyte monitoring is of importance in these patients.

Front 16

Which type of acid base imbalance would you expect to see in the following patient type: A 22 year old primigravida who has been in labor for 14 hours. She has had a difficult time breathing with her contractions and now complains of numbness and tingling of her hands and feet.
What nursing interventions are necessary at this time?

Back 16

Respiratory alkalosis
The treatment for this is to have the patient rebreathe her own expiration by either having her breathe in a paper bag, or give her an oxygen mask without the oxygen on until symptoms resolve. Teach her how to take slower breathes and discuss further pain management.

Front 17

ABG results are as follows:

pH 7.09. pCO2 86, HCO3 26
Oxygen Saturation is 86 on room air
Patient is newly admitted for chest pain.

What nursing interventions are necessary at this time?

Back 17

This is Respiratory Acidosis
Treatment
Elevate the HOB
Apply Oxygen at 100% per non rebreather mask
Place patient on a cardiac monitor and monitor oxygen saturation
Assess pain and administer meds as ordered

Front 18

ABG results:

pH. 7.64, pCO2 38, HCO3 33
Oxygen Saturation is 88 on room air

Patient is a 4 year old admitted for massive vomiting of 1-2 times every 15 minutes for the past 24 hours. His cap refill is 6 seconds. He is listless and does not fight off lab sticks.

Identify the imbalance and discuss nursing interventions necessary at this time.

Back 18

Metabolic alkalosis

This patient needs to have oxygen at 100% per non re breather and IV access started immediately. He aldo requires bolus dosing of fluids at 20 ml/kg until capillary refill time is within < 3-5 seconds.
The patient also needs to be on a cardiac monitor with pulse oximetry. The patient will most likely go to ICU until stable.