Professional Documents
Culture Documents
IS IT COMPENSATED OR UNCOMPENSATED
HCO3 = Bicarbonate :
MIDDLE RANGE
(ACIDOSIS) (ALKASOSIS)
PH METABOLIC
Step IV. Look at the HCO3 ( BICARBONATE)
Hсоз ACIDOSIS
HCO3 high ( above 26) M. ALKALOSIS
pCO2 high low
HCO3 low ( below 22) M. ACIDOSIS
Acid-base imbalances
MIDDLE RANGE
1. Respiratory
Acid – 22 24 26 - Base
(ACIDOSIS) (ALKALOSIS) pH pCO2
Step V. Determine the primary ACID-BASE disturbance. Acidosis low high Opposite
Alkalosis high low directions
• The change that matches the pH is the primary ACID-
BASE DISTURBANCE.
pH HCO3
i.e. both are high or both are low then the acid-base imbalance
b. pH ACIDOSIS METABOLIC is compensated.
HCO3 ACIDOSIS ACIDOSIS
• Example;
• Therefore : If pH are primarily affected
PCO2 (same interpretation) • PaCo2 high (ACIDOSIS) HCO3 high (ALKALOSIS)
• PaCo2. low (ALKALOSIS) HCO3 low (ACIDOSIS )
RESPIRATORY ACID-BASE IMBALANCE OCCURS
• When is the acid-base imbalance considered as partial or
• Therefore: If pH are primarily affected complete compensation?
HCO3 (same interpretation)
1. When the acid-base balance is compensated, but the
METABOLIC ACID-BASE IMBALANCE OCCURS pH is still
Think about ROME ABNORMAL: PARTIAL COMPENSATION.
• R espiratory 2. When the acid-base balance is compensated, and the
pposite pH is
• M etabolic
• E- qual NORMAL: COMPLETE COMPENSATION.
1. RESPIRATORY ACID – BASE IMBALANCES • When is the acid - base imbalance considered
uncompensated?
• Respiratory Opposite means : the directions of pH and • When the CO2 and HCO3 levels move towards
paCO2 are opposite. opposite directions. ( the problem is worsened)
• Samples : Example:
pH RESPIRATORY PaCO2 . high (ACIDOSIS) HCO3 low (ACIDOSIS)
PaCo2 ACIDOSIS
PaCo2 low (ALKALOSIS) HCO3 high (ALKALOSIS)
PULSE OXIMETRY
Procedure
Bronchial hygiene
low-flow systems
o provides the
Types of oxygen device highest
concentration of
1. Nasal cannula (nasal prongs)
oxygen and can deliver an FIO2 higher than Abdominal breathing
90%, depending on the client's ventilatory Blowing exercises
pattern.
used in the client with a deteriorating respiratory Pursed lip breathing
status who might require intubation
- can slow down breathing, reducing the work of
Has a one-way valve between the mask and the
breathing by keeping your airways open longer.
reservoir and two flaps over the exhalation ports.
- This makes it easier for the lungs to function and
The valve allows the client to draw the entire quantity improves the exchange of oxygen and carbon dioxide.
of oxygen from the reservoir bag.
The flaps prevent room air from entering through the • Indicated for conditions can include;
exhalation ports.
During exhalation, air leaves through these exhalation obstructive lung disease, such as: asthma,
ports while the one-way valve prevents exhaled air restrictive lung disease, such as pulmonary fibrosis
from reentering the reservoir bag. (PE), which is a type of interstitial lung disease
5. Venturi mask Practice technique four (4) to five (5) times daily until patient
can manage the breathing patter, then anytime patient feel
High-flow oxygen delivery system involves a short of breath.
mechanism that pulls in a specific proportional
amount of room air for each liter of oxygen delivered. To practice the pursed-lips breathing technique:
An adapter is located between the bottom of the mask
is a technique used to relieve shortness of breath.
and the oxygen source; the adapter contains holes of
Breathe in slowly through nose with mouth closed for
different sizes that allow only specific amounts of air
2 seconds, feeling the air move into your abdomen.
to mix with the oxygen.
Try to fill your abdomen with air instead of just your
24% to 55% FIO2, with flow rates
lungs..
The adapter allows selection of the amount of oxygen
Then, purse lips as if you were about to whistle.
desired of4to 10L/min
Finally, breathe out through your pursed lips to a
Interventions count of four.
Then repeat. Over time, you can increase the inhale
Monitor the client closely to ensure accurate rate flow and exhale counts from 2 seconds to 4 seconds, and
rate for a specific FiO2. so on.
keep the air entrapment port for the Venturi adapter
open and uncovered to ensure adequate oxygen
delivery.
Ensure that the mask fits snugly and that the tubing is
free of kinks, because the FIO2 is altered if kinking
occurs or if the mask fits poorly.
Assess the client for dry mucous membranes;
humidity or aerosol can be added to the system.