Acidosis: Clinical Manifestations Quick Review

 

Acidosis is the total concentration of buffer base is lower than normal, with a relative increase in hydrogen ion concentration; thus a greater number of hydrogen ions is circulating in the blood than can be absorbed by the buffer system.

Clinical Manifestations of Acidosis

Respiratory (↑ Pco2)	Metabolic (↓ HCO-3 )
Neurological
Drowsiness Disorientation Dizziness Headache Coma	Drowsiness Confusion Headache Coma
Cardiovascular
Decreased blood pressure Ventricular fibrillation (related to hyperkalemia from compensation) Warm, flushed skin (related to peripheral vasodilation)	Decreased blood pressure Dysrhythmias (related to hyperkalemia from compensation ) Warm, flushed skin (related to peripheral vasodilation)
Gastrointestinal
No significant findings	Nausea, vomiting, diarrhea, abdominal pain
Neuromuscular
Seizures	No significant findings
Respiratory
Hypoventilation with hypoxia (lungs are unable to compensate when there is a respiratory problem)	Deep, rapid respirations (compensatory action by the lungs)

 

Causes of Respiratory Acidosis

■ Asthma

■ Atelectasis

■ Brain trauma

■ Bronchiectasis

■ Bronchitis

■ Central nervous system depressants

■ Emphysema

■ Hypoventilation

■ Pneumonia

■ Pulmonary edema

■ Pulmonary emboli

 

Nursing Interventions

 

1. Monitor for signs of respiratory distress.
2. Administer oxygen as prescribed.
3. Place the client in a semi-Fowler’s position.
4. Encourage and assist the client to turn, cough, and deep-breathe.
5. Prepare to administer respiratory treatments as prescribed.
6. Encourage hydration to thin secretions.
7. Suction the client’s airway, if necessary.
8. Reduce restlessness by improving ventilation rather than by administering tranquilizers, sedatives, or opioids because these medications further depress respirations.

9. Monitor electrolyte values, particularly the potassium level.
10. Administer antibiotics for respiratory infection or other medications as prescribed.
11. Prepare for endotracheal intubation and mechanical ventilation if CO2 levels rise above 50 mm Hg and if signs of acute respiratory distress are present.