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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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Normal Values ::
Normal Values and Acceptable Ranges of the ABG Elements
ABG Element
Normal Value
Range
pH
7.4
7.35 to 7.45
Pa02
90mmHg
80 to 100 mmHg
Sa02
93 to 100%
PaC02
40mmHg
35 to 45 mmHg
HC03
24mEq/L
22 to 26mEq/L
Remember: Definitions
Acidosis (acidemia) occurs when pH drops below 7.35
Alkalosis (alkalemia) occurs when the pH rises above 7.45
A primary respiratory problem is determined if the PaC02 is less than 35mmHg(alkalosis) or greater than 45 mmHg(acidosis).
A primary metabolic problem is when the HC03 is less than 22mEq/L (acidosis) or greater than 26mEq/L(alkalosis).
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