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Metabolic Acidosis
Clinical Manifestations
- hyperkalemia: shift of acid to ICF and K+ to the ECF
- anorexia, nausea, and vomiting
- warm, flushed skin
- cardiac dysrhythmias & CNS dysfunction
- headache, diarrhea, tremors
Metabolic Alkalosis
Clinical Manifestations
- cardia dysrhythmias; seizures; confusion; muscle twitching, agitation
- >pH;>HC03; normal PaCo2 or elevated if compensation occurs
Respiratory Acidosis
Clinical Manifestations
- > PaCo2; HCO3 is normal or > with renal compensation
- vasodilatation; cardiac dysrhythmias, tachycardia, somnolence, decreased ventilation
Respiratory Alkalosis
Clinical Manifestations
- > pH; < PaC02; HCO3 normal or low due to compensation
- nausea, vomiting, tingling of fingers
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There are three critical questions to keep in mind when attempting to interpret arterial blood gases (ABGs).
First Question: Does the patient exhibit acidosis or alkalosis?
Second Question: What is the primary problem? Metabolic? or Respiratory?
Third Question: Is the patient exhibiting a comensatory state?
These essential questions will guide you while you analyze ABGs.
In order to understand ABG analysis and remember what is abnormal, we would be wise to review what is normal.
Therefore, lets look at some normal range values and definitions
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