Metabolic Acidosis Metabolic Alkalosis Definition: INCREASE in hydrogen ions (acid) and LOSS of bicarb (basic) Cause: Ketoacidosis, renal failure, GI loss of bicarb (diarrhea), fistula, intestinal malabsorption, ileostomy, aspirin poisoning Manifestations: Confusion, headache, n/v, lower BP, cardiac dysrhythmias, stupor, dizziness, drowsiness Treatment: Give IV-Bicarb, Insulin if diabetic, fluids Nursing Care: VS, monitor cardiac rhythm, neuro status, and REALLY monitor potassium levels because as hydrogen ions enter the cell so does potassium Definition: DECREASED in hydrogen ions (acidic) and a GAIN of bicarb (basic) Cause: Vomiting, NG suction, ingestion of antacids that contain bicarb. Manifestations: Confusion, tetany, weakness, hyperreflexia, hypotension, seizures, respiratory failure Treatment: Give Diamox to make Bicarb excrete out of the body, give K+ and NaCl fluid, antiemetic to treat vomiting Nursing Care: Vs, cardiac arrhythmias, seizures precautions, EKG, irrigate NG with NaCl to prevent loss of GI Respiratory Acidosis Respiratory Alkalosis Definition: INCREASE in hydrogen ions (acidic), DECREASED in Bicarb (basic). Cause: HYPOventilation aka NOT breathing enough, COPD, Guillain-Barre, sedatives Manifestations: Headache, n/v, blurred vision, confusion, altered mental status, cardiac arrest, restlessness Treatment: Improve ventilation, give Bronchodilators, antibiotics, oxygen, chest physiotherapy Nursing Care: VS, monitor change in respirations, neurostatus, arrhythmias, assess ABG Definition: DECREASE in hydrogen ions (acidic), and INCREASE in bicarb (basic) Cause: HYPERventilation aka breathing to fast, panic attacks, CPR ventilation Manifestations: Dizziness, numbness, tingling around the mouth or hands or feet, dyspnea, anxiety, tremors, seizures, tetany Treatment: Figure out the cause and go from there, treat sepsis, reduce fever, calm pt down Nursing Care: assess respiratory status, ABG monitoring, decreased patient anxiety, seizures precautions, need oxygen