Question

Concepts of respiratory and metabolic acidosis and respiratory and metabolic alkalosis. Include lab and blood gas values, causes and treatment, as well as signs and symptoms in each of the four conditions. Highlight similarities and differences... Provide your summary with rationale following APA guidelines

Answer 1

* Acidosis and Alkalosis

       * Acidosis

               * It is defined as a condition in which addition of acid or removal of alkali from the system.

               * Acidosis is divided into respiratory acidosis and metabolic acidosis.

     * Respiratory acidosis

               * It is due to the retension of CO2 due to hypoventillation result in decreased PH

                  increase CO2 level in blood.

           Signs and symptoms

                    * Anxiety

                    * Blurried vision.

                    * Confusion.

                    * Restlessness and headache.

           Causes

                  * Respiratory center depression.

                  * Obsruction to respiratory passage.

                  * Emphysema.

                  * Fibrosis of lung.

           Treatment

            * Use of bronchodilators to reverse airway obstruction.

          * CPAP or BiPAP ventilltion to maintain normal gas exchange in lngs.

            * Oxygen administration to avoid increase CO2 level in blood.

   * Metabolic acidosis

         * It is due to the addition of acids or removal of bases.

         * In metabolic acidosis pH,PaCO2 level and HCO3(Bicarbonate) level decreases.

Signs and symptoms

       * Shallow breathing.

       * Sleepleness.

       * Anorexia.

         * Tachycardia.

           * Jaundice.

   Causes

         * Diabetic melitus.

         * Renal failure.

         * Loss of bases from extracellular fluid in cases of diarrhoea leads to acidosis.

       * Severe exercises

            * Starvation.

   Treatment

        * Insulin therpy for patient with DM to balace pH and correct acidosis.

            * Sodium citrate used for patient with kidney failure to correct acidosis.

          *Bicarbonate supplements used to regain bicarbonate level in the blood.

Alkalosis

       * It is defind as the condition in which bases are added or acids are removed excessively

          from the system.

       * It is divided into metabolic alkalosis and respiratory alkalosis

                 Respiratory alkalosis

                       * In this hyperventillation resut in elimination of more CO2 so PaCO2 become decreases

                          pH increases(H+ decreases) and bicarbonate level decreased.

                     Signs and symptoms

                          * Numbness and muscle spasm.

                        * Dry mouth.

                        * Bloating.

                        * Tingling sensation in the arms.

                   Causes

                          * High attitude.

                          * Voluntary hyperventillation.

                  Treatment

                           * Restrict high oxygen intake into lungs.

                         * Reassurance and use paper bags to breath patient can fill the bag with CO2

                               by exhalation into it.

   Metabolic acidosis

            * In metabolic acidosis increasing plasma HCO3 leads to increase in pH.

          Signs and symptoms

               * Lightheadedness.

               * Muscle spasms.

             * Confusion.

               * Tremors in hands.

          Causes

                     * Excessive vomitting.

               * Cushing's syndrome.

             * Hypokalemia.

               * Primary hyperaldosteronism.

               * Use of diuretics like thiazides,loop diuretics.

   Treatment

            * Control vomitting using antiemetics.

              * Administration of mineral acids.

              * Fluid and electrolyte therapy to correct acid base imbalance.

Summary

        Acid-Base conditions ----------------------------------------- Abnormality

        Respiratory acidosis ------------------------------------------ Increase in Paco2.

        Respiratory alkalosis-------------------------------------------Decrease in Paco2.

      Metabolic acidosis   --------------------------------------------Decrease in HCO3.

    Metabolic alkalosis -------------------------------------------- Increase in HCO3.