Acid Base Review：酸碱审查.pptVIP

Acid/ Base Review NR-75 D Diana Diaz RN MSN Objectives Review the basic mechanisms of acid/base Recall the 4 major types of Acid/base imbalances Analyze a set of blood gas values pH and Hydrogen Ion Indirect measure of H+ ion concentration Ratio of base (HCO3) to acid (CO2) Acids give up (donate) H+ ions, while bases pick up H+ ions pH Body maintains a slightly alkaline pH of 7.35 - 7.45 Metabolic and respiratory processes work together to keep hydrogen (H+) levels in a normal range Regulators of Acid/Base Buffers Respiratory system Renal system Acid – Base Balance ABG Normal Values pH 7.35 - 7.45 overall state PaCO2 35 - 45 mm Hg (respiratory component) HCO3 22 - 26 mEq/L (metabolic component) ABG Normal Values PaO2 80 - 100 mmHg partial pressure of oxygen in arterial blood SaO2 96 - 100% arterial O2 saturation ABG Normal Values pH 7.35 - 7.45 overall state PaCO2 35 - 45 mm Hg (respiratory component) HCO3 22 - 26 mEq/L (metabolic component) Acid-Base Imbalances Alkalemia Alkalosis Acidemia Acidosis Metabolic Acidosis Metabolic Alkalosis Respiratory Acidosis Respiratory Alkalosis Interpretation of ABGs Evaluate pH: this determines acidosis or alkalosis 7.40 is in the middle of the normal range of 7.35 - 7.45 Value below 7.40 is moving towards acidosis Value above 7.40 is moving towards alkalosis Interpretation of ABGs Evaluate respiratory component (PaCO2) If PaCO2 35, the value is alkalotic If PaCO2 45, the value is acidotic Interpretation of ABGs Evaluate the metabolic component (HCO3) If HCO3 26 mEq/L, the value is alkalotic If HCO3 22 mEq/L, the value is acidotic Interpretation of ABGs Determine which component (PaCO2 or HCO3) matches the pH If pH is decreased or increased is the underlying disorder respiratory or metabolic? Interpretation of ABGs Respiratory ↑ pH, ↓ PaCO2 ↓ pH, ↑ PaCO2 Metabolic ↑ pH, ↑ HCO3 ↓ pH, ↓ HCO3 Compensation Determine the degree of compensation Absent: pH is not within normal range The component that