ACID BASE

BALANCE
Amy J. Herrington
Ferris State University
NURS 621

OBJECTIVES
Identify the role of acid base balance in the body

Discuss the importance of maintaining acid base balance

Describe the types of acid base imbalances
Explain the clinical management of acid base imbalance
Explain assessment of a patient with acid base imbalance

ACID BASE BALANCE: OVERVIEW

Dynamic Process Homeostasis

Imbalance affects cellular function Affecting all functions of body

Imbalance r/t underlying condition

(EDWARDS, 2008; GIDDENS, 2013)

ACID BASE BALANCE: OVERVIEW

Important Terms
Acid
Base
pH
HCO3 (bicarbonate)
H2CO3 (Carbonic Acid)

Acid Base Balance

Optimal balance
Acidosis
Alkalosis

(EDWARDS, 2008; GIDDENS, 2013)

INTERRELATED CONCEPTS
Fluid & Electrolyte Balance
Oxygenation
Perfusion
Nutrition
Elimination

Cognition

(GIDDENS, 2013)

PATHOPHYSIOLOGY
Acid Production

Acid Buffering
Acid Excretion

(EDWARDS, 2008; GIDDENS, 2013; LEHNE,

2013)

ACID BASE BALANCE: PPP CONNECTION

Those at greatest risk of acid base imbalance
Excessive Production or Intake of Metabolic Acid
Altered Acid Buffering due to Loss or Gain of Bicarbonate
Altered Acid Excretion
Abnormal shift of H+ into Cells

(EDWARDS, 2008; GIDDENS, 2013; LEHNE,

2013)

PHYSICAL EXAM
Underlying Condition or Fluid Electrolyte Imbalance
Nonspecific Signs & Symptoms
Current Health Conditions
Focus
Respiratory
Renal
Other Conditions

Recent History
Vomiting/Diarrhea
Use of heartburn/indigestion medications
Diets, Medications, Supplements, Alcohol

Diagnostics

(BALL ET AL., 2015; GIDDENS, 2013)

ACID BASE BALANCE: PPP CONNECTION

(BALL ET AL., 2015; GIDDENS, 2013)

PHARMACOLOGY
Aggressive management

Respiratory Support
Fluid Electrolyte Support

(GIDDENS, 2013; LEHNE, 2013)

PPP CONNECTION
Primary Prevention

Nursing Interventions
Safety
Promote Compensatory Mechanisms
Education
Monitor for Complications of therapy

(GIDDENS, 2013)

RESEARCH
Comparison of the Effects of Normal Saline Versus Plasmalyte on Acid-

Base Balance During Living Donor Kidney Transplantation Using the

Stewart and Base Excess Methods
Ischemia-reperfusion injury r/t kidney transplant
Metabolic acidosis

Compares the effects of NS and Plasmalyte on acid-base balance and electrolytes

NS and Plasmalyte both safe
Acid-base and Electrolyte balance more stable with Plasmalyte

(KIM ET AL., 2013)

THEORY OF SYMPTOM SELF

MANAGEMENT

(HOFFMAN, 2013)

TEACHING TOOL
Case Studies
Engage Students
Higher Order Thinking
Apply Skills and Knowledge
Learn from Others

Concept Mapping
Knowledge and Organization on

Paper
Visual Learners

ROME METHOD

SELF REFLECTION

CONCLUSION

REFERENCES
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidels Guide
to Physical Examination (8th ed.). St. Louis, MO: Mosby-Elsevier.
Edwards, S. L. (2008). Pathophysiology of acid base balance: The theory of practice
relationship. Intensive and Critical Care Nursing, 24, p. 28-40.
Giddens, J. F. (2013). Concepts for Nursing Practice. St. Louis, MO: Mosby-Elsevier.
Hoffman, A. J. (2013). Enhancing self-efficacy for optimized patient outcomes through the
theory of symptom self-management. Cancer Nursing, 36(1), p. 16-26.
Kim, S. Y., Huh, K. H., Lee, S. H., Jeong, S. H., & Choi, Y. S. (2013). Comparison of the
effects of normal saline versus plasmalyte on acid-base balance during living donor
kidney transplantation using the stewart and base excess methods. Transplantation
Proceedings, 45, p. 2191-2196.
Lehne, R. A. (2013). Pharmacology in Nursing Care (8th ed.). St. Louis, MO: Mosby-Elsevier.