Imbalance

Metabolic
Acidosis

Causes

Manifestations

Management

renal failure, diabetes

(DKA), anaerobic
metabolism, lactic
acidosis, anoxia,
poisoning, overdose

if decrease is slow, patient may be

asymptomatic until bicarbonate is 15 mEq/L

vomiting or gastric
suction; medications,
especially long-term
diuretic use; hypokalemia

symptoms related to decreased calcium,

respiratory depression, tachycardia, and
symptoms of hypokalemia

Correct underlying disorder

Monitor I&O
Supply chloride to allow excretion of excess
bicarbonate, a
Restore fluid volume with sodium chloride
solutions

Respiratory Hypoventilation
Acidosis
respiratory problems with
inadequate excretion of
CO2: pulmonary edema,
aspiration, atelectasis,
pneumothorax, overdose
of sedatives, sleep apnea
syndrome, COPD,

chronic respiratory acidosis, the body may

compensate and may be asymptomatic

Treatment is aimed at improving ventilation:

semi-fowler's position, bronchodilators,
Mechanical ventilation

Respiratory Hyperventilation: anxiety,

Alkalosis
hypoxemia, the early
phase of salicylate
intoxication, gramnegative bacteremia, and
inappropriate ventilator
settings

lightheadedness, inability to concentrate,

numbness and tingling, and sometimes loss of
consciousness

Metabolic
Alkalosis

headache, confusion, drowsiness, respiratory

rate & depth, blood pressure,
cardiac output, dysrhythmias, shock;
May cause hyperkalemia
May cause hypocalcemia in chronic conditions

symptoms may include a suddenly increased

pulse, respiratory rate, and BP; mental changes;
feeling of fullness in the head

Correct the underlying problem

Bicarbonate may be administered
Correct hyperkalemia and possible
Hypocalcemia
Monitor potassium and calcium levels

hydration

ICP in severe cases.

Correcting the underlying problem.
Correct cause of hyperventilation,
Sedatives,
instructed to breathe more slowly,