Fluid & Electrolytes vs. Acid/Base tips

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Specializes in LDRP.

We just had a F & E test & it did not go so well. I am asking for any tips on how to study & prepare for Acid/Base. I didn't find F & E to be really that difficult but I just had a difficult time getting through all of the material & having enough time to study it. What is better/worse about Acid/Base studying ?

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Acid Base Disorders

- pH

o Normal values ~ 7.35-7.45

o

o >7.45 ~ Alkalosis

- PaCO2

o Normal values ~ 35-45 mmHg

o >45 mmHg ~ acidosis (respiratory)

hypercapnia ~ carbon dioxide is being retained

o

hypocapnia ~ carbon dioxide is being exhaled

- HCO3

o Normal values ~ 22-26 mEq/L

o

bicarbonate levels lower than normal

o >26 ~ alkalosis (metabolic)

bicarbonate levels higher than normal

- Respiratory Acidosis

o pH

o PaCO2 > 45 mmHg

Symptoms

- Rapid, shallow respirations

- Dyspnea, SOB

- Disorientation

- Muscle Weakness

Common Causes

- Acute Respiratory Acidosis

o Acute respiratory conditions (pulmonary edema, acute asthma, pneumonia)

o Opiate overdose

o Foreign body aspiration

o Chest trauma

- Chronic Respiratory Acidosis

o Chronic respiratory conditions (COPD, cystic fibrosis)

o Multiple sclerosis, other neuromuscular diseases

o Stroke

Common Nursing Diagnoses

- Impaired Gas Exchange

- Ineffective Airway Clearance

- Respiratory Alkalosis

o pH > 7.45

o PaCO2

Symptoms

- Tingling of extremities

- Confusion

- Deep, rapid breathing

- Seizures

Common Causes

- Anxiety-induced hyperventilation

- Fever

- Early salicylate intoxication

- Hyperventilation with mechanical ventilator

Common Nursing Diagnoses

- Ineffective Breathing Pattern

- Risk for Injury

- Metabolic Acidosis

o pH

o PaCO2

Symptoms

- Disorientation

- Kussmaul respirations

- Muscle twitching

- Changes in LOC

Common Causes

- Increased acid production

o Lactic acidosis

o Ketoacidosis related to diabetes, starvation, or alcoholism

o Salicylate toxicity

- Decreased Acid excretion

o Renal failure

- Increased Bicarbonate loss

o Diarrhea, ileostomy drainage, intestinal fistula

o Biliary or pancreatic fistulas

- Increased Chloride

o Sodium chloride IV solutions

o Renal tubular acidosis

o Carbonic anhydrase inhibitors

Common Nursing Diagnoses

- Decreased Cardiac Output

- Risk for FVE

- Rick for Injury

- Metabolic Alkalosis

o pH > 7.45

o PaCO2 > 26 mEq/L

Symptoms

- Nausea and vomiting

- Diarrhea

- Restlessness

- Slow respirations

- Arrhythmias

Common Causes

- Increased acid loss or excretion

o Vomiting, gastric suction

o Hypokalemia

- Increased Bicarbonate

o Alkali ingestion (bicarbonate of soda)

o Excess Bicarbonate administration

Common Nursing Diagnoses

- Risk for Impaired Gas Exchange

- Deficient Fluid Volume

- Acid Base Mnemonic

o Respiratory

o Opposite

pH á PCO2 â Alkalosis (respiratory)

pH â PCO2 á Acidosis (respiratory)

o Metabolic

o Equal

pH á HCO3 á Alkalosis (metabolic)

pH â HCO3 â Acidosis (metabolic)

These are my notes I used to prepare for the Acid Base Balance in which I well. The key is to try to understand and relate them to diseases. Make flashcards and keep reviewing everyday, even if it is only for 15 minutes. That is what I did. Good luck to you.

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great advice, i learned using the flashcards and still use them yrs down the line as a refresher.

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