Metabolic acidosis

Nursing interventions
- Monitor Arterial Blood Gases values
- Administer IV sodium bicarbonate carefully if ordered
- Correct underlying problem as ordered

Alkalosis: - is acid-base imbalance in which there is a decrease in H+ concentration below 35 n mol/L and an increase in the PH in excess of 7.45 due to carbonic acid deficit or an excess amount of bicarbonate (HCO3).

Types of Alkalosis
1. Respiratory Alkalosis
2. Metabolic Alkalosis

Respiratory Alkalosis
Causes
1. Hyperventilation (excessive loss of carbolic acid) related to anxiety, hysteria, CNS disease which causes over stimulation of respiratory center
2. High fever
3. Hypoxia
4. Sever pain
5. High altitude

Sign and Symptoms
- Serum PH > 7.45
- Serum bicarbonate decreases
- Serum hydrogenion < 35 n mol/L
- Serum potassium decreased
- Cardiac arrythemia
- Increased Na+ and K+ excretion in urine
- Decreased chloride ion and hydrogenion excretion
- Hyperventilation
- Increased rate and depth of respiration
- Decreased arterial blood CO2
- Dizzness, tetany, muscle spasm (carpopedal spasm)
- Cramp, tingling in extremities
- Convulsion

Nursing Interventions
- Monitor vital signs and ABGs
- Assist client to breath more slowly
- Administer CO2 inhalations, or help client breath in a paper bag (to inhale CO2)

Metabolic Alkalosis
Causes
1. Abnormal loss of acid associated with vomiting and aspiration
2. Diuretics – through excess urination
3. Excessive ingestion of alkaline e.x. sodium bicarbonate

Sign and system
- Scrum PH > 7.45
- Scrum H+ < 35 n mal/L
- Increase serum bicarbonate
- Decreased serum potassium
- Cardiac arrhythmia
- Hypoventilation
- Slow, shallow respiration
- Increased PaCO2 or normal
- Decreased PaO2 if prolonged alkalosis
- Increased sodium and potassium ions excretion
- Decreased chloride and hydrogen ions excretions
- Dizziness, tremer, twitching, tetany, cramping, tingling in limbs, convulsion
- Others like nausea, vomiting and diarrhea

Nursing Interventions
- Monitor clients fluid losses closely
- Monitor vital signs, especially respirations
- Administer ordered IV fluids carefully
- Reverse underlying problems