Acidosis: Clinical Manifestations Quick Review

 

Acidosis is the total concentration of buffer base is lower than normal, with a relative increase in hydrogen ion concentration; thus a greater number of hydrogen ions is circulating in the blood than can be absorbed by the buffer system.

Clinical Manifestations of Acidosis

Respiratory (↑ Pco2) Metabolic (↓ HCO-3 )
Neurological
Drowsiness
Disorientation
Dizziness
Headache
Coma
Drowsiness
Confusion
Headache
Coma
Cardiovascular
Decreased blood pressure
Ventricular fibrillation (related to hyperkalemia from compensation)
Warm, flushed skin (related to peripheral vasodilation)
Decreased blood pressure
Dysrhythmias (related to hyperkalemia from compensation )
Warm, flushed skin (related to peripheral vasodilation)
Gastrointestinal
No significant findings Nausea, vomiting, diarrhea, abdominal pain
Neuromuscular
Seizures No significant findings
Respiratory
Hypoventilation with hypoxia (lungs are unable to compensate when there is a respiratory problem)Deep, rapid respirations (compensatory action by
the lungs)

 

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Respiratory Acidosis Mnemonic

Causes of Respiratory Acidosis

■ Asthma

■ Atelectasis

■ Brain trauma

■ Bronchiectasis

■ Bronchitis

■ Central nervous system depressants

■ Emphysema

■ Hypoventilation

■ Pneumonia

■ Pulmonary edema

■ Pulmonary emboli

 

Nursing Interventions

 

  1. Monitor for signs of respiratory distress.
  2. Administer oxygen as prescribed.
  3. Place the client in a semi-Fowler’s position.
  4. Encourage and assist the client to turn, cough, and deep-breathe.
  5. Prepare to administer respiratory treatments as prescribed.
  6. Encourage hydration to thin secretions.
  7. Suction the client’s airway, if necessary.
  8. Reduce restlessness by improving ventilation rather than by administering tranquilizers, sedatives, or opioids because these medications further depress respirations.
  1. Monitor electrolyte values, particularly the potassium level.
  2. Administer antibiotics for respiratory infection or other medications as prescribed.
  3. Prepare for endotracheal intubation and mechanical ventilation if CO2 levels rise above 50 mm Hg and if signs of acute respiratory distress are present.

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