Imbalance

Causes

Assessment findings

Nursing Interventions

Primary ¯ in concentration of base bicarbonate in extracellular fluid, ¯ pH and bicarbonate, (¯ CO₂ if lung compensation)

Diabetic ketoacidosis, uremia, starvation, diarrhea, severe infections, renal tubular acidosis

Headache, nausea/vomiting, weakness lethargy, disorientation, tremors, convulsions, coma

Admin sodium bicarbonate as ordered, monitor for signs of hyperkalemia. Provide Alkaline mouthwash (baking soda & water) to neutralize acids, lubricate lips to prevent dryness from hyperventilation. Measure I&O, seizure precautions, monitor arterial blood gasses and electrolytes.

Primary ^ of base bicarbonate in extracellular fluid, ^ pH and bicarbonate,( ^ CO₂ if lung compensation)

Severe vomiting, NG suctioning, diuretic therapy, excessive ingestion of sodium bicarbonate, biliary drainage

Nausea vomiting, diarrhea, numbness & tingling of extremities, tetany, bradycardia, decreased respirations

Replace fluid and electrolyte losses (potassium & Chloride), seizure precautions, I &O, assess 4 hypokalemia, monitor arterial blood gasses and electrolytes.

Primary ^ of carbonic acid in extracellular fluid, ¯ pH, ^ CO_{2 (}and bicarbonate if renal compensation ^)

COPD, barbiturate or sedative OD, acute airway obstruction, weakness of respiratory muscles

HA, weakness, visual disturbances, rapid respirations, confusion, drowsiness, tachycardia, coma

Semi Fowlers, patent airway, TCDB, postural drainage, admin fluids to help liquefy secretions (unless contraindicated), admin low concentration oxygen therapy, , monitor arterial blood gasses and electrolytes., prophylactic antibiotics as ordered.

Primary ¯ of carbonic acid in the extracellular fluid, ^ pH, ¯ CO_{2 (}and bicarbonate if renal compensation)

Hyperventilation, mechanical over ventilation, encephalitis

Numbness and tingling of mouth and extremities, inability to concentrate, rapid respirations, dry mouth coma

Reassure, encourage breathing into bag, or holding breath, adequate rest, sedation as ordered, monitor mechanical ventilation, monitor arterial blood gasses and electrolytes.