3 Nursing Care for Acid–Base Imbalances Free Online FlashCards

What are typical adult reference ranges for pH, $PaCO_2$, and $HCO_3^-$?

Typical adult ranges are pH $7.35–7.45$, $PaCO_2$ $35–45\ \mathrm{mmHg}$, and $HCO_3^-$ $22–26\ \mathrm{mEq/L}$; use the laboratory’s reference ranges.

What should a nurse assess first when an acid–base imbalance may be urgent?

Assess airway, breathing, circulation, mental status, and vital signs first. Escalate worsening breathing, falling oxygen saturation, new confusion, hypotension, dysrhythmia, or rapidly changing results.

How do acidosis and acidemia differ?

Acidosis and alkalosis are processes that tend to lower or raise pH. Acidemia and alkalemia describe a measured blood pH below or above the reference range.

How does the ROME rule help identify a primary acid–base disorder?

Check pH, then assess $PaCO_2$ and $HCO_3^-$. In a primary respiratory disorder, $PaCO_2$ changes opposite to pH; in a primary metabolic disorder, $HCO_3^-$ changes in the same direction as pH.

What does compensation do to pH, and what does a normal-range pH fail to rule out?

Compensation moves pH toward normal but does not by itself explain an abnormal result. A pH within range can still reflect a compensated or mixed disorder.

How is the anion gap calculated?

The anion gap is calculated as $Na^+ - (Cl^- + HCO_3^-)$. Interpret it using the laboratory’s reference range and the clinical picture.

How does oxygenation relate to acid–base status?

Oxygen saturation and $PaO_2$ help assess oxygenation, which is related to but distinct from acid–base status. Assess oxygenation alongside the ABG.

What are nursing priorities for respiratory acidosis?

Prioritize airway and ventilation. Assess respiratory effort and breath sounds, support prescribed oxygen and ventilatory care, and report declining consciousness or ventilation; oxygen alone does not correct inadequate ventilation.

What is a key safety priority when a patient has respiratory alkalosis?

Assess oxygenation and investigate serious causes rather than assuming anxiety. Do not use paper-bag rebreathing, which can worsen hypoxemia.

What causes and monitoring priorities are important in metabolic acidosis?

Possible causes include ketoacidosis, lactic acidosis, kidney dysfunction, toxins, and bicarbonate loss such as severe diarrhea. Monitor breathing, perfusion, mental status, glucose, electrolytes, and renal function while addressing the cause.

What should nurses monitor in metabolic alkalosis?

Track intake and output, volume status, and potassium, chloride, and magnesium; use ECG monitoring when indicated. Vomiting, gastric suction, diuretics, or excess alkali may contribute.

How should a nurse evaluate response to acid–base treatment?

Reassess respiratory effort, oxygenation, mental status, hemodynamics, urine output, fluid balance, and relevant ECG or electrolyte findings. A better pH alone does not establish a safe response.