Tricia Shared "Acid-Base" - 11 Picmonics
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Acid-Base
Metabolic Acidosis Assessment
- Characteristics
- Decreased pH < 7.35
- Decreased HCO3 < 22
- Signs & Symptoms
- Abdominal Pain
- CNS Depression
- Coma
- Hypotension
- Arrhythmias
- Increased Respirations
- Kussmaul Respirations
- Flushed, Warm, Dry Skin
- Muscle Weakness
2 mins
Metabolic Alkalosis Assessment
- Signs and Symptoms
- Increased pH > 7.45
- Increased HCO3 > 26
- Excitable State
- Arrhythmias
- Paresthesias
- Muscle Cramps
- Muscle Weakness
- Decreased Respiratory Effort
1 min
Metabolic Alkalosis Interventions
- Interventions
- Treat Underlying Cause
- Stop Potassium (K+) Wasting Diuretics
- Spironolactone
- Acetazolamide
- IV Fluids
- Sodium Chloride
- Replace Potassium (K+)
- Considerations
- Monitor Respiratory Rate
- Monitor Heart Rate
- Seizure Precautions
2 mins
Metabolic Acidosis Interventions
- Interventions
- Raise Plasma pH > 7.20
- Treat Underlying Cause
- Sodium Bicarbonate
- Considerations
- Follow ABGs
- Continuously Monitor Patient
2 mins
Respiratory Acidosis
- Hypoventilation
- Increased PaCO2 > 45
- Barbiturates Depress Central Respiratory Center of Brain
- Opioids Depress Central Respiratory Center of the Brain
- Airway Obstruction
- Respiratory Muscle Weakness/Paralysis
3 mins
Respiratory Acidosis Interventions
- Improve Respiration
- Pharmacologic Interventions
- Bronchodilators
- Respiratory Stimulants
- Drug Antagonists
- Nonpharmacologic Interventions
- Oxygen
- Assisted Ventilation
- Prevent Complications
1 min
Respiratory Acidosis Assessment
- Assessment
- Decreased pH < 7.35
- Increased PaCO2 > 45
- Reduced Respirations
- Anxiety
- Change in LOC
- Tachycardia
- Cyanosis
- Increased Electrolytes
- ECG Changes
- Muscle Weakness
- Hyporeflexia
2 mins
Respiratory Alkalosis Assessment
- Assessment
- Increased pH > 7.45
- Decreased PaCO2 < 35 mmHg
- Hyperventilation
- Brainstem Stimulation
- Head Injury
- Shock
- Lightheadedness
- Tingling Lips or Fingers
- Trousseau's
- Chvostek's Sign
- Anxiety
2 mins
Respiratory Alkalosis Interventions
- Treat Underlying Cause
- Mechanically Ventilated Patients
- Decrease Tidal Volume and/or Respiratory Rate
- Give Adequate Pain Control and Sedation
- Hyperventilation Syndrome
- Sedatives
- Antidepressants
- Considerations
- Compensatory Drop in Serum Bicarbonate
- Calming Breathing Exercises
- Correct CO2 Slowly
2 mins
Blood Acid-Base Control
- Characteristics
- In a State of Acidemia
- Medullary Chemoreceptors Control Ventilation Rate
- Expulsion of CO2 through Lungs Increases pH
- Bicarbonate Reabsorption from the Kidney Increases pH
- Kidney Excretion of H+ Increases pH
2 mins
How to Interpret Acid Base Disorders
- pH, pCO2, HCO3 (Bicarbonate)
- Step 1
- pH
- Acidosis
- Alkalosis
- Step 2
- pCO2
- Opposite Direction As pH
- Respiratory Acidosis
- Respiratory Alkalosis
- Step 3
- HCO3 (Bicarbonate)
- Same Direction As pH
- Metabolic Acidosis
- Metabolic Alkalosis
3 mins
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