Acid-base imbalances alkalosis

Two adjectives describe the general cause or origin of pH imbalances in body fluids metabolic and respiratory. Respiratory acid-base imbalances (respiratory acidosis and respiratory alkalosis) result from abnormal breathing patterns. Metabolic acidosis and metabohc alkalosis are caused by factors other than abnormal breathing. 

As stated in the introductory chapters, acid-base balance is focused on regulating the hydrogen ion concentration. When body fluids have an excessive hydrogen ion concentration, the patient is deemed to be in a state of acidosis. When the hydrogen ion concentration is low, the patient is in a state of alkalosis. Compensation of an acid-base imbalance can occur when the body has partially adjusted, returning the acid-base balance to normal, even though bicarbonate and carbon dioxide levels remain abnormal. The underlying problem must be corrected to fully reverse the imbalance. 

Treatment of alkalosis depends on finding the specific cause. For alkalosis caused by hyperventilation, breathing into a paper bag causes more CO to be retained. Oxygen may be administered via a rebreathing mask to prevent decreased oxygenation and hypoxemia. Electrolyte supplements or medications to bind excessive electrolytes may be administered to establish an acid-base balance until the underlying problem has been corrected. Monitor treatment closely and patient responses to avoid overcompensation. Monitor vital signs and laboratory tests because acid-base imbalance and related electrolyte imbalances can result in cardiac dysfunction. 

The primary complication of pregnancy that places the mother at risk for fluid, electrolyte, and acid-base imbalance in the early stages of pregnancy is hyperemesis gravidarum (prolonged nausea with vomiting). The loss of fluids, decreased intake owing to nausea, and loss of stomach acids predispose the woman to dehydration and alkalosis with related electrolyte imbalance. 8... 

In all cases of acid-base imbalance, three basic rules should be followed (1) rely on a medical doctor for diagnosis and prescribed treatment, (2) treat the primary cause of the acidosis or alkalosis, and (3) make every effort to aid the various compensatory responses of the lungs and kidneys. 

The pH indicates an excess presence of hydrogen ions termed acidosis (pH < 7.35) or low levels of hydrogen ions termed alkalosis (pH > 7.45). The pH only determines the overall state of acid-base balance but does not indicate the source of the imbalance uidess viewed in combination with other test values (Pco and HCO ). 4... 

If the acidosis causing the hyperkalemia is extreme, bicarbonate may be administered to restore acid-base balance. If other electrolyte imbalances are noted, the appropriate treatment (e.g., chloride replacement) should be implemented. Care should be taken when providing supplements for electrolyte replacement. Electrolyte and acid-base levels should be monitored carefully to prevent overtreatment and additional electrolyte imbalance or alkalosis. 

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