The nurse preceptor is reviewing acid-base imbalances with a new nurse and identifies which of the following clients as the most likely to have respiratory acidosis?


• Hypoventilation will retain CO2 that would normally be expired during respiration. PCO2 will become elevated, causing respiratory acidosis.

Respiratory Acidosis:
• Respiratory system is the cause, for ex. hypoventilation
• Increase in PCO2, decrease in pH
• Compensation - Kidneys reabsorb Bicarb (HCO3).

Metabolic Acidosis:
• Caused by loss of bicarb or build up of acids, for ex. lactic acidosis, diarrhea, renal failure, ketones, ammonium intoxication; not caused by respiration.
• HCO3 decreases, pH decreases
• Compensation - hyperventilation to eliminate CO2

Respiratory Alkalosis:
• Caused by excessive ventilation
• Decrease in PCO2, increase in pH
• Compensation - Kidneys excrete HCO3.

Metabolic Alkalosis:
• Acid (H+) lost from emesis, diuretics. Retention of HCO3 from medications, hyperaldosteronism
• Increase in HCO3, Increase in pH
• Compensation - Respiratory centers are not stimulated, which leads to hypoventilation and CO2 retention.

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