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What Are The Symptoms Of Acidosis And Alkalosis

Acidosis

Acidosis

When your body fluids contain too much acid, it’s known as acidosis. Acidosis occurs when your kidneys and lungs can’t keep your body’s pH in balance. Many of the body’s processes produce acid. Your lungs and kidneys can usually compensate for slight pH imbalances, but problems with these organs can lead to excess acid accumulating in your body. The acidity of your blood is measured by determining its pH. A lower pH means that your blood is more acidic, while a higher pH means that your blood is more basic. The pH of your blood should be around 7.4. According to the American Association for Clinical Chemistry (AACC), acidosis is characterized by a pH of 7.35 or lower. Alkalosis is characterized by a pH level of 7.45 or higher. While seemingly slight, these numerical differences can be serious. Acidosis can lead to numerous health issues, and it can even be life-threatening. There are two types of acidosis, each with various causes. The type of acidosis is categorized as either respiratory acidosis or metabolic acidosis, depending on the primary cause of your acidosis. Respiratory acidosis Respiratory acidosis occurs when too much CO2 builds up in the body. Normally, the lungs remove CO2 while you breathe. However, sometimes your body can’t get rid of enough CO2. This may happen due to: chronic airway conditions, like asthma injury to the chest obesity, which can make breathing difficult sedative misuse deformed chest structure Metabolic acidosis Metabolic acidosis starts in the kidneys instead of the lungs. It occurs when they can’t eliminate enough acid or when they get rid of too much base. There are three major forms of metabolic acidosis: Diabetic acidosis occurs in people with diabetes that’s poorly controlled. If your body lacks enough insulin, keton Continue reading >>

Etiology And Clinical Manifestations ::

Etiology And Clinical Manifestations ::

Etiology and Clinical Manifestations :: Metabolic Acidosis Etiology: Loss of base: such as in cases of severe diarrhea or Gain of metabolic acids: Anaerobic metabolism; Drug overdose (e.g.salicylates); Renal failure; Diabetic ketoacidosis Manifestations: headache and lethargy are early symptoms; warm flushed skin; seizures; mental confusion; muscle twitching; agitation; coma (severe acidosis); anorexia, nausea, vomiting and diarrhea; deep and rapid respirations (Kussmaul respirations); hyperkalemia (shift of acid to the ICF and K+ to the ECF); cardiac dysrhythmias. Decreased blood pH; decreased HCO3; normal PaCO2 or decreased if compensation is occurring. (The "nursing interventions" button on the homepage will lead the user to these nursing interventions listed under each problem. It would be nice to have a pull-down menu under "nursing interventions" for metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis) on the homepage). Nursing Interventions: Assess the clinical symptoms, health history, and lab results. Identify the underlying cause to intervene appropriately. When there is sever acidosis (pH < 7.1), sodium bicarbonate is necessary to bring the pH to a safe level. Correct the sodium and water deficits, as well. Metabolic Alkalosis Etiology: Loss of metabolic acids: such as in cases of prolonged vomiting or gastrointestinal suctioning. Hyperaldosteronism can cause sodium retention and loss of hydrogen ions and potassium. or Gain of Base: an increased intake of bicarbonate. Diuretics (e.g. furosemide) can cause sodium, potassium, and chloride excretion more than bicarbonate excretion. Manifestations: general weakness, muscle cramps, hyperactive reflexes, tetany (due to a decrease in calcium); shallow and slow respirations; confu Continue reading >>

Merck And The Merck Manuals

Merck And The Merck Manuals

Alkalosis is excessive blood alkalinity caused by an overabundance of bicarbonate in the blood or a loss of acid from the blood (metabolic alkalosis), or by a low level of carbon dioxide in the blood that results from rapid or deep breathing (respiratory alkalosis). The acidity or alkalinity of any solution, including blood, is indicated on the pH scale. If too much bicarbonate in the blood, a loss of acid from the blood or a low level of carbon dioxide in the blood overwhelms the body's acid-base control systems, the blood will become alkalotic. Alkalosis is categorized depending on its primary cause as Metabolic alkalosis Metabolic alkalosis develops when the body loses too much acid or gains too much base. For example, stomach acid is lost during periods of prolonged vomiting or when stomach acids are suctioned with a stomach tube (as is sometimes done in hospitals). In rare cases, metabolic alkalosis develops in a person who has ingested too much base from substances such as baking soda (bicarbonate of soda). In addition, metabolic alkalosis can develop when excessive loss of fluids and electrolytes (such as sodium or potassium) affects the kidneys' ability to maintain the blood's acid-base balance. For instance, loss of potassium sufficient to cause metabolic alkalosis may result from an overactive adrenal gland or the use of diuretics. Respiratory alkalosis Respiratory alkalosis develops when rapid, deep breathing (hyperventilation) causes too much carbon dioxide to be expelled from the bloodstream. The most common cause of hyperventilation, and thus respiratory alkalosis, is anxiety. Other causes of hyperventilation and consequent respiratory alkalosis include pain, low levels of oxygen in the blood, fever, and aspirin overdose (which can also cause metabolic aci Continue reading >>

Metabolic Acidosis And Alkalosis

Metabolic Acidosis And Alkalosis

Your blood contains many substances that help your body function. To function properly, your blood keeps a balance between substances that are acidic and substances that are alkaline (base). Normally, your body naturally maintains this balance, called your blood pH level. However, certain health conditions and substances can upset this balance. If your blood has too much acid or too little base in it, you may develop metabolic acidosis. Alcohol, aspirin and poisons, like carbon monoxide or cyanide, can all cause your body to make too much acid. Conditions like kidney disease or Type 1 diabetes can also affect how acidic your blood is. If your blood has too much base, you may develop metabolic alkalosis. This can happen if you lose too much acid due to using diuretics, vomiting, or if your adrenal gland is overactive. What are the symptoms of metabolic acidosis and alkalosis? If you have metabolic acidosis, you may have no symptoms. However, most people experience nausea, vomiting and fatigue (feeling tired and weak.) You may also start to breathe deeper and faster. These symptoms can get worse the longer you experience acidosis. Without treatment, you acidosis can lead to shock, coma or even death. Metabolic alkalosis, on the other hand, can cause irritability, muscle cramps and twitches. If left untreated, you can experience long-term muscle spasms. How are metabolic acidosis and alkalosis treated? Doctors can diagnose acidosis and alkalosis with a blood test. The blood test shows if your body’s pH levels are out of balance. Your doctor will design a treatment for your acidosis or alkalosis based on what caused the condition. For instance, if Type 1 diabetes led to diabetic ketoacidosis, your doctor will use insulin to balance out your blood sugar and get rid of exce Continue reading >>

Acidosis

Acidosis

For acidosis referring to acidity of the urine, see renal tubular acidosis. "Acidemia" redirects here. It is not to be confused with Academia. Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increased hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma. The term acidemia describes the state of low blood pH, while acidosis is used to describe the processes leading to these states. Nevertheless, the terms are sometimes used interchangeably. The distinction may be relevant where a patient has factors causing both acidosis and alkalosis, wherein the relative severity of both determines whether the result is a high, low, or normal pH. Acidosis is said to occur when arterial pH falls below 7.35 (except in the fetus – see below), while its counterpart (alkalosis) occurs at a pH over 7.45. Arterial blood gas analysis and other tests are required to separate the main causes. The rate of cellular metabolic activity affects and, at the same time, is affected by the pH of the body fluids. In mammals, the normal pH of arterial blood lies between 7.35 and 7.50 depending on the species (e.g., healthy human-arterial blood pH varies between 7.35 and 7.45). Blood pH values compatible with life in mammals are limited to a pH range between 6.8 and 7.8. Changes in the pH of arterial blood (and therefore the extracellular fluid) outside this range result in irreversible cell damage.[1] Signs and symptoms[edit] General symptoms of acidosis.[2] These usually accompany symptoms of another primary defect (respiratory or metabolic). Nervous system involvement may be seen with acidosis and occurs more often with respiratory acidosis than with metabolic acidosis. Signs and symptoms that may be seen i Continue reading >>

Respiratory Alkalosis

Respiratory Alkalosis

Background Respiratory alkalosis is a disturbance in acid and base balance due to alveolar hyperventilation. Alveolar hyperventilation leads to a decreased partial pressure of arterial carbon dioxide (PaCO2). In turn, the decrease in PaCO2 increases the ratio of bicarbonate concentration to PaCO2 and, thereby, increases the pH level, thus the descriptive term of respiratory alkalosis. The decrease in PaCO2 (hypocapnia) develops when a strong respiratory stimulus causes the respiratory system to remove more carbon dioxide than is produced metabolically in the tissues. Respiratory alkalosis can be acute or chronic. In acute respiratory alkalosis, the PaCO2 level is below the lower limit of normal and the serum pH is alkalemic. In chronic respiratory alkalosis, the PaCO2 level is below the lower limit of normal, but the pH level is relatively normal or near normal. Respiratory alkalosis is the most common acid-base abnormality observed in patients who are critically ill. It is associated with numerous illnesses and is a common finding in patients on mechanical ventilation. Many cardiac and pulmonary disorders can manifest with respiratory alkalosis as an early or intermediate finding. When respiratory alkalosis is present, the cause may be a minor, non–life-threatening disorder. However, more serious disease processes should also be considered in the differential diagnosis. Continue reading >>

Acid & Alkaline Nutrition: Shattering The Myths

Acid & Alkaline Nutrition: Shattering The Myths

According to Guy Schenker, DC: Acid/alkaline imbalances always involve respiratory function Acid/alkaline imbalances always involve renal function "The respiratory and renal involvement in an acidosis or alkalosis may be either part of the cause of, or part of the compensation for the acidosis or alkalosis...The most alarming misconception among nutritionists concerned with pH balance, one seems to reign supreme in the minds of an appalling majority of doctors, is that ACIDOSIS is ubiquitous among the sick of this world. Acidosis, they have been given to believe, is an accompaniment to, and even the primary cause of, every disease, every pain, every state of ill health to afflict humankind. "Wouldn’t it be nice if it were that simple? Pump up your patients’ alkaline reserves and cure them of anything? "And an ALKALOSIS? No such thing? Acid is bad, this theory contends, and alkaline is good. And there is no way one can have too much of a good thing. "In truth excess alkalinity is just as harmful as excess acidity. To clear the confusion, all physiological systems are maintained through a negative feedback mechanism that operates in a dualistic manner. Dualistic means that for every normal condition, there are 2 abnormals-abnormally high and abnormally low. To say that there is only one abnormal with respect to pH balance is to display total ignorance of the most basic fundamentals of physiology.” -‘An Analytical System of Clinical Nutrition’, -Guy Schenker, DC, 1989-2010 Your pH balance is uniquely yours Have you had enough of the half-truths about pH balance? Michael and Julie’s metabolic expertise will sort it out for you “In a metabolic alkalosis, there are increasing levels of bicarbonate ion in relation to H+. There are 3 main causes of bicarbonate inc Continue reading >>

Acidosis Or Alkalosis

Acidosis Or Alkalosis

Sleuthing: Using Blood Values to determine the Cause of Acidosis or Alkalosis Note the pH. This tells you whether the person is in acidosis (pH < 7.35) or alkalosis (pH > 7.45); but it does not tell you the cause. Next, check the PCO2 to see if this is the cause of the acid-base imbalance. Because the respiratory system is a fast-acting system, an excessively high or low PCO2 may indicate either that the condition is respiratory system—caused or that the respiratory system is compensating. For example, if the pH indicates acidosis and: The PCO2 is over 45 mm Hg, the respiratory system is the cause of the problem and the condition is a respiratory acidosis. The PCO2 is below normal limits (below 35 mmHg), the respiratory system is not the cause but is compensating. The PCO2 is within normal limits; the condition is neither caused nor compensated by the respiratory system. Check the bicarbonate level. If step 2 proves that the respiratory system is not responsible for the imbalance, then the condition is metabolic and should be reflected in increased or decreased bicarbonate levels. Metabolic acidosis is indicated by HCO3– values below 22 mEq/L, and metabolic alkalosis by values over 26 mEq/L. Notice that whereas PCO2 vary inversely with blood pH (PCO2 rises as blood pH falls), HCO3– levels vary directly with blood pH (increased HCO3– results in increased pH). Beyond this bare-bones approach there is something else to consider when you are assessing acid-base problems. If an imbalance is fully compensated, the pH may be normal even when the pH is normal, carefully scrutinize the PCO2 or HCO3– values for clues to what imbalance may be occurring. Causes and Consequences of Acid-Base imbalances Metabolic acidosis: Uncompensated (uncorrected) HCO3– < 22 mEq/L; pH Continue reading >>

Metabolic Alkalosis Nclex Review Notes

Metabolic Alkalosis Nclex Review Notes

Are you studying metabolic alkalosis and need to know a mnemonic on how to remember the causes? This article will give you a clever mnemonic and simplify the signs and symptoms and nursing interventions on how to remember metabolic alkalosis for nursing lecture exams and NCLEX. In addition, you will learn how to differentiate metabolic alkalosis from metabolic acidosis. Don’t forget to take the metabolic acidosis and metabolic alkalosis quiz. This article will cover: Metabolic alkalosis simplified Lab values expected with metabolic alkalosis Causes of metabolic alkalosis Signs and symptoms of metabolic alkalosis Nursing interventions for metabolic alkalosis Lecture on Metabolic Alkalosis Metabolic Alkalosis Metabolic alkalosis in simple terms: a metabolic problem caused by the excessive loss of acids (H+) or increased amount of bicarb (HCO3) produced in the body that leads to an alkalotic state in the body. Disease processes and drugs can cause metabolic alkalosis. When metabolic alkalosis happens in the body other systems try to compensate by hopefully fixing the blood’s pH and bicarb level. One system that does this is the respiratory system by stimulating the respiratory system to hypoventilate (decrease respirations) which will retain PCO2 (carbon dioxide) so it will decrease the pH back to normal, hence you will start to see bradypnea in your patient. If a patient is experiencing metabolic alkalosis they will present with the following labs: HCO3: increases >26 Blood pH: increases >7.45 CO2: >45 or normal (may be normal but if increased this is the body’s way of trying to compensate. Remember the respiratory system tries to decrease the pH from its alkalotic state by causing hypoventilation ( bradypnea). The respiratory system hopes that if the CO2 increase e Continue reading >>

Acid Base Statuses

Acid Base Statuses

A B Metabolic Acidosis (1) results from cold stress Respiratory Alkalosis (1) results from excessive CO2 blown off Body decr carbonic acid (1) results in slow respirations so that CO2 is retained Acidosis (1) symptoms (a) CNS depression (b) errors in judgment (c) disorientation (d) drowsiness (e) stupor (f) coma Hydrogen Ions excess (1) results in acidosis as pH falls below 7.35 (2) hydrogen ions are forced into the cells causing K+ to move into the cells Diabetic Ketoacidosis metabolic acidosis Metabolic Acidosis dehydration after an extended bout of diarrhea COPD respiratory acidosis Diarrhea (1) respirtory acidosis Anxiety (1)results in respiratory alkalosis (2) associated w/hyperventilation (2) during hyperventilation CO2 is blown off which lowers the amount of acid in the system Severe Asthma Respiratory Alkalosis Acute Renal Failure (1) metabolic acidosis (2) hypermagnesemia (3) hyperkalemia (4) hypocalcemia Diarrhea (1) metabolic acidosis (2) leads to meta acid because there is an over-elimination of bicarbonate Alkalosis (1) signs (a) tingling fingers, toes & face (b) estreme nervousness (c) twitching of muscles (d) tetany Severe Asthma respiratory acidosis Vomiting (1) metabolic alkalosis (2) leads to metabolic alkalosis as hydrochloric acid is lost from the stomach Aspirin metabolic acidosis Overdose of Morphine respiratory acisosis Vigorous Diuresis metabolic alkalosis End Stage Muscular Distrophy respiratory acidosis Severe Hypokalemia metabolic alkalosis Renal Failure (1) results in metabolic acisosis as fluid build up turns acidic Shock (1) metabolic acidosis (2) meta acid because acid is added to the system (3) anaerobic metabolic pathways result in lactate and hydrogen irons (forming lactic acid) Hyperventilation (1) respiratory alkalosis (2) leads to re Continue reading >>

Merck And The Merck Manuals

Merck And The Merck Manuals

Acidosis is caused by an overproduction of acid in the blood or an excessive loss of bicarbonate from the blood (metabolic acidosis) or by a buildup of carbon dioxide in the blood that results from poor lung function or depressed breathing (respiratory acidosis). If an increase in acid overwhelms the body's acid-base control systems, the blood will become acidic. As blood pH drops (becomes more acidic), the parts of the brain that regulate breathing are stimulated to produce faster and deeper breathing (respiratory compensation). Breathing faster and deeper increases the amount of carbon dioxide exhaled. The kidneys also try to compensate by excreting more acid in the urine. However, both mechanisms can be overwhelmed if the body continues to produce too much acid, leading to severe acidosis and eventually heart problems and coma. The acidity or alkalinity of any solution, including blood, is indicated on the pH scale. Metabolic acidosis develops when the amount of acid in the body is increased through ingestion of a substance that is, or can be broken down (metabolized) to, an acid—such as wood alcohol (methanol), antifreeze (ethylene glycol), or large doses of aspirin (acetylsalicylic acid). Metabolic acidosis can also occur as a result of abnormal metabolism. The body produces excess acid in the advanced stages of shock and in poorly controlled type 1 diabetes mellitus (diabetic ketoacidosis). Even the production of normal amounts of acid may lead to acidosis when the kidneys are not functioning normally and are therefore not able to excrete sufficient amounts of acid in the urine. Major Causes of Metabolic Acidosis Diabetic ketoacidosis (buildup of ketoacids) Drugs and substances such as acetazolamide, alcohols, and aspirin Lactic acidosis (buildup of lactic acid Continue reading >>

Alkalosis

Alkalosis

Your blood is made up of acids and bases. The amount of acids and bases in your blood can be measured on a pH scale. It’s important to maintain the correct balance between acids and bases. Even a slight change can cause health problems. Normally, your blood should have a slightly higher amount of bases than acids. Alkalosis occurs when your body has too many bases. It can occur due to decreased blood levels of carbon dioxide, which is an acid. It can also occur due to increased blood levels of bicarbonate, which is a base. This condition may also be related to other underlying health issues such as low potassium, or hypokalemia. The earlier it’s detected and treated, the better the outcome is. Acid-base balance » There are five main types of alkalosis. Respiratory alkalosis Respiratory alkalosis occurs when there isn’t enough carbon dioxide in your bloodstream. It’s often caused by: hyperventilation, which commonly occurs with anxiety high fever lack of oxygen salicylate poisoning being in high altitudes Metabolic alkalosis Metabolic alkalosis develops when your body loses too much acid or gains too much base. This can be attributed to: excess vomiting, which causes electrolyte loss overuse of diuretics a large loss of potassium or sodium in a short amount of time antacids accidental ingestion of bicarbonate, which can be found in baking soda laxatives alcohol abuse Hypochloremic alkalosis Hypochloremic alkalosis occurs when there’s a significant decline of chloride in your body. This can be due to prolonged vomiting or sweating. Chloride is an important chemical needed to maintain balance in bodily fluids, and it’s an essential part of your body’s digestive fluids. Hypokalemic alkalosis Hypokalemic alkalosis occurs when your body lacks the normal amount Continue reading >>

Metabolic Acidosis

Metabolic Acidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find one of our health articles more useful. See also separate Lactic Acidosis and Arterial Blood Gases - Indications and Interpretations articles. Description Metabolic acidosis is defined as an arterial blood pH <7.35 with plasma bicarbonate <22 mmol/L. Respiratory compensation occurs normally immediately, unless there is respiratory pathology. Pure metabolic acidosis is a term used to describe when there is not another primary acid-base derangement - ie there is not a mixed acid-base disorder. Compensation may be partial (very early in time course, limited by other acid-base derangements, or the acidosis exceeds the maximum compensation possible) or full. The Winter formula can be helpful here - the formula allows calculation of the expected compensating pCO2: If the measured pCO2 is >expected pCO2 then additional respiratory acidosis may also be present. It is important to remember that metabolic acidosis is not a diagnosis; rather, it is a metabolic derangement that indicates underlying disease(s) as a cause. Determination of the underlying cause is the key to correcting the acidosis and administering appropriate therapy[1]. Epidemiology It is relatively common, particularly among acutely unwell/critical care patients. There are no reliable figures for its overall incidence or prevalence in the population at large. Causes of metabolic acidosis There are many causes. They can be classified according to their pathophysiological origin, as below. The table is not exhaustive but lists those that are most common or clinically important to detect. Increased acid Continue reading >>

Metabolic Acidosis And Alkalosis

Metabolic Acidosis And Alkalosis

Page Index Metabolic Acidosis. Metabolic Alkalosis Emergency Therapy Treating Metabolic Acidosis Calculating the Dose Use Half the Calculated Dose Reasons to Limit the Bicarbonate Dose: Injected into Plasma Volume Fizzes with Acid Causes Respiratory Acidosis Raises Intracellular PCO2 Subsequent Residual Changes Metabolic Acidosis. The following is a brief summary. For additional information visit: E-Medicine (Christie Thomas) or Wikepedia Etiology: There are many causes of primary metabolic acidosis and they are commonly classified by the anion gap: Metabolic Acidosis with a Normal Anion Gap: Longstanding diarrhea (bicarbonate loss) Uretero-sigmoidostomy Pancreatic fistula Renal Tubular Acidosis Intoxication, e.g., ammonium chloride, acetazolamide, bile acid sequestrants Renal failure Metabolic Acidosis with an Elevated Anion Gap: lactic acidosis ketoacidosis chronic renal failure (accumulation of sulfates, phosphates, uric acid) intoxication, e.g., salicylates, ethanol, methanol, formaldehyde, ethylene glycol, paraldehyde, INH, toluene, sulfates, metformin. rhabdomyolysis For further details visit: E-Medicine (Christie Thomas). Treating Severe Metabolic Acidosis. The ideal treatment for metabolic acidosis is correction of the underlying cause. When urgency dictates more rapid correction, treatment is based on clinical considerations, supported by laboratory evidence. The best measure of the level of metabolic acidosis is the Standard Base Excess (SBE) because it is independent of PCO2. If it is decided to administer bicarbonate, the SBE and the size of the treatable space are used to calculate the dose required: Metabolic Alkalosis Etiology: Primary Metabolic alkalosis may occur from various causes including: Loss of acid via the urine, stools, or vomiting Transfer of Continue reading >>

Disorders Of Acid-base Balance

Disorders Of Acid-base Balance

Learning Objectives By the end of this section, you will be able to: Identify the three blood variables considered when making a diagnosis of acidosis or alkalosis Identify the source of compensation for blood pH problems of a respiratory origin Identify the source of compensation for blood pH problems of a metabolic/renal origin Normal arterial blood pH is restricted to a very narrow range of 7.35 to 7.45. A person who has a blood pH below 7.35 is considered to be in acidosis (actually, “physiological acidosis,” because blood is not truly acidic until its pH drops below 7), and a continuous blood pH below 7.0 can be fatal. Acidosis has several symptoms, including headache and confusion, and the individual can become lethargic and easily fatigued. A person who has a blood pH above 7.45 is considered to be in alkalosis, and a pH above 7.8 is fatal. Some symptoms of alkalosis include cognitive impairment (which can progress to unconsciousness), tingling or numbness in the extremities, muscle twitching and spasm, and nausea and vomiting. Both acidosis and alkalosis can be caused by either metabolic or respiratory disorders. As discussed earlier in this chapter, the concentration of carbonic acid in the blood is dependent on the level of CO2 in the body and the amount of CO2 gas exhaled through the lungs. Thus, the respiratory contribution to acid-base balance is usually discussed in terms of CO2 (rather than of carbonic acid). Remember that a molecule of carbonic acid is lost for every molecule of CO2 exhaled, and a molecule of carbonic acid is formed for every molecule of CO2 retained. Metabolic Acidosis: Primary Bicarbonate Deficiency Metabolic acidosis occurs when the blood is too acidic (pH below 7.35) due to too little bicarbonate, a condition called primary bicar Continue reading >>

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