2. METABOLIC ACIDOSIS
Too much acid build up in the body which affects the bicarbonate levels
Key concepts:
increased acid production
decreased acid excretion
loss of bicarbonates
3. CAUSES OF METABOLIC ACIDOSIS
A C I D O T I C
Aspirin toxicity
Carbohydrates not metabolized
Insufficiency of kidneys
Diarrhea
Osteomy drainage
fistula
Intake of high fat diet
Carbonic anhydrase inhibitors
4. METABOLIC ALKALOSIS
Too much base build up in the body fluid
Key concepts:
excessive loss of acids (Hydrogen ions)
increase in the amount of bicarbonates in the body.
5. CAUSES OF METABOLIC ALKALOSIS
A L K A L I
Aldosterone production being excess, hyperaldosteronism
Loop diuretics or thiazides.
alkali ingestion e.g. milk, baking soda, antacids
Anticoagulant “citrate” in blood transfusion or renal replacement therapy
Loss of fluids (vomiting, NG sanction)
Increased sodium bicarbonate administration trying to correct acidosis
6. PH, HCO3, PaCO2,
Metabolic acidosis and alkalosis is affected by the bicarbonate levels
Respiratory alkalosis and acidosis is affected by the CO2 levels
PH = Hydrogen ions
HCO3= Bicarbonate ions
PaCO2= CO2 concentration.
[CO2] + [H20] ↔ [H2CO3] ↔ [HC03-] + [H+]
7. LAB VALUES
PH HCO3 PaCO2
ACIDOSIS LESS THAN 7.35 LESS THAN 22 LESS THAN 35
NORMAL 7.35 – 7.45 22 - 26 35 - 45
ALKALOSIS MORE THAN 7.45 MORE THAN 26 MORE THAN 45 OR
NORMAL
8. COMPENSTATION
In acidosis the compensation is through hyperventilation ( kussmaul’s breathing)
In alkalosis the compensation is by hypoventilation (bradypenea)
The treatment depends on the cause for each .
9. THE END.
REVISION QUESTIONS:
https://www.registerednursern.com/metabolic-alkalosis-and-metabolic-acidosis-nclex-quiz-
acid-base-imbalances-quiz/
