How to Interpret Acid Base Disorders
- pH, pCO₂, HCO₃ (Bicarbonate)
 - pH
 - Acidosis
 - Alkalosis
 - pCO₂
 - Opposite Direction as pH
 - Respiratory Acidosis
 - Respiratory Alkalosis
 - HCO₃ (Bicarbonate)
 - Same Direction as pH
 - Metabolic Acidosis
 - Metabolic Alkalosis
 
Respiratory Acidosis Assessment
- Decreased pH < 7.35
 - Increased PaCO2 > 45
 - Reduced Respirations
 - Anxiety
 - Change in LOC
 - Tachycardia
 - Cyanosis
 - Increased Electrolytes
 - ECG Changes
 - Muscle Weakness
 - Hyporeflexia
 
Respiratory Acidosis Interventions
- Improve Respiration
 - Bronchodilators
 - Respiratory Stimulants
 - Drug Antagonists
 - Oxygen
 - Assisted Ventilation
 - Prevent Complications
 
Respiratory Alkalosis 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
 
Respiratory Alkalosis Interventions
- Treat Underlying Cause
 - Decrease Tidal Volume and/or Respiratory Rate
 - Give Adequate Pain Control and Sedation
 - Sedatives
 - Antidepressants
 - Compensatory Drop in Serum Bicarbonate
 - Calming Breathing Exercises
 - Correct CO2 Slowly
 
Metabolic Acidosis Assessment
- Decreased pH < 7.35
 - Decreased HCO3 < 22
 - Abdominal Pain
 - CNS Depression
 - Coma
 - Hypotension
 - Arrhythmias
 - Increased Respirations
 - Kussmaul Respirations
 - Flushed, Warm, Dry Skin
 - Muscle Weakness
 
Metabolic Acidosis Interventions
- Raise Plasma pH > 7.20
 - Treat Underlying Cause
 - Sodium Bicarbonate
 - Follow ABGs
 - Continuously Monitor Patient
 
Metabolic Alkalosis Assessment
- Increased pH > 7.45
 - Increased HCO3 > 26
 - Excitable State
 - Arrhythmias
 - Paresthesias
 - Muscle Cramps
 - Muscle Weakness
 - Decreased Respiratory Effort
 
Metabolic Alkalosis Interventions
- Treat Underlying Cause
 - Stop Potassium (K+) Wasting Diuretics
 - Spironolactone
 - Acetazolamide
 - IV Fluids
 - Sodium Chloride
 - Replace Potassium (K+)
 - Monitor Respiratory Rate
 - Monitor Heart Rate
 - Seizure Precautions