NSG 223 Exam 2: NSG 223 Exam 2 Study

NSG 223 Exam 2: NSG 223 Exam 2 Study

Guide

Metabolic Acidosis: ABG interpretation

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• low bicarbonate level less than 22 mEq/L and a low pH less than 7.35.

The cardinal feature is a decrease in the serum bicarbonate level.

Metabolic Alkalosis: ABG interpretation

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• pH greater than 7.45 and a serum bicarbonate concentration greater than

26

Respiratory Acidosis: ABG interpretation

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• pH is less than 7.35 and PaCO2 is greater than 45 and a compensatory

increases HCO3

Respiratory Alkalosis:

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• pH is greater than 7.45 and the PaCO2 is less than 35

Treatments for Metabolic Acidosis Medical Management:

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• Give Bicarb
• Chronic metabolic acidosis treat calcium levels first
• Avoid tetany
• Watch for hypernatremia, hyperkalemia, and hypocalcemia

Treatments for Metabolic Alkalosis Medical Management:

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• Restore fluid volume
• Give electrolytes as needed (Sodium chloride and Potassium chloride) 1 / 3

• Give Tagamet
• Hypokalemia- Urine Chloride, ID the cause

Treatments for each ABG Imbalance: Acute Respiratory Acidosis

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• Underlying cause
• Bronchodilators
• BiPAP

Treatments for each ABG Imbalance: Chronic Respiratory Acidosis

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• Antibiotics
• Diuretics
• Bronchodilators
• Corticosteroids
• Mechanical ventilation

Treatments for each ABG Imbalance: Respiratory Alkalosis

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• Breathe into a bag- raise CO2
• Reassure patient
• Pursed lip breathing

Acute and Chronic causes of the 4 imbalances: Metabolic Acidosis

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• Build up of acid in the body due to kidney failure or disease
• Kidneys are unable to remove enough acid from your blood
• Hypocalcemia

Acute and Chronic causes of the 4 imbalances: Metabolic Alkalosis

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• High pH, high plasma bicarbonate concertation
• Gastric suctioning, vomiting, diuretic use from potassium loss, Cushing's

syndrome, long term diuretic and antacid use.

• / 3

Acute and Chronic causes of the 4 imbalances: Respiratory Acidosis

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• Hypoventilation- inadequate excretion of CO2, High CO2 levels
• Acute pulmonary edema, Severe pneumonia, and acute respiratory

distress syndrome

• Chronic hypercapnia- excessive CO2 in the blood
• Chemoreceptors in your brain alerted to elevated CO2- Ventilation

Acute and Chronic causes of the 4 imbalances: Respiratory Alkalosis

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• Hyperventilation- panic attack or anxiety, Low CO2 levels
• Asthma

- COPD

• PE

Clinical manifestations of the 4 imbalances: Metabolic Acidosis

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• Headache
• Confusion
• Increased respiratory rate and depth
• Hypotension
• Cool clammy skin
• Dysrhythmias

Clinical manifestations of the 4 imbalances: Metabolic Alkalosis

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• Hypercalcemia
• Hypertonic muscles
• Depressed respirations
• Hypokalemia
• Decreased motility and paralytic ileus
• Potassium decreases- PVCs or U waves are seen on ECCG
• / 3