METABOLIC

ACIDOSIS

Irish Grace A. Dayao Dra. Ramos

III-BN
METABOLIC ACIDOSIS
•Isa pH imbalance in which the body has
accumulated too much acid and does not
have enough bicarbonate to effectively
neutralize the effects of the acid.

•Is a condition that occurs when the body

produces too much acids or when the
kidneys are not removing enough acid from
the body.
Metabolic acidosis (primary base
bicarbonate [HCO3] deficiency) reflects
an excess of acid (hydrogen) and a deficit
of base (bicarbonate) resulting from acid
overproduction, loss of intestinal
bicarbonate, inadequate conservation of
bicarbonate, and excretion of acid, or
anaerobic metabolism.
Metabolic acidosis is classified into two
groups:
1.) High anion gap acidosis – occurs in
diabetic ketoacidosis; severe
malnutrition or starvation, alcoholic
lactic acidosis; renal failure; high-fat,
low-carbohydrate diets/lipid
administration; poisoning, e.g., salicylate
intoxication (after initial stage);
paraldehyde intoxication; and drug
therapy, e.g., acetazolamide (Diamox),
NH4Cl.
2.) Normal anion gap acidosis – is
associated with loss of bicarbonate
form the body, as may occur in renal
tubular acidosis, hyperalimentation,
vomiting/diarrhea, small-
bowel/pancreatic fistulas, and
ileostomy and use of IV sodium
chloride in presence of preexisting
kidney dysfunction, acidifying drugs
(e.g., ammonium chloride).
Causes:
TYPES OF METABOLIC ACIDOSIS

1.) Diabetic acidosis (also called diabetic

ketoacidosis and DKA) - develops when
substances known as ketone bodies, which are
acidic, build up during uncontrolled diabetes.
2.) Hyperchloremic acidosis - results from
excessive loss of sodium bicarbonate from the
body, as can happen with severe diarrhea.
TYPES OF METABOLIC ACIDOSIS
3.) Lactic acidosis - is a buildup of lactic acid.
It can be caused by:
•Alcohol
•Cancer
•Exercising for a very long time
•Liver failure
•Low blood sugar (hypoglycemia)
•Medications such as salicylates
•Prolonged lack of oxygen from shock, heart failure, or
severe anemia
•Seizures
Other causes of metabolic acidosis

•Kidney disease (distal tubular acidosis

and proximal renal tubular acidosis)
•Diabetic ketoacidosis
•Swallowing antifreeze
•Too much aspirin consumption
•Severe dehydration
•Cyanide poisoning
Signs and symptoms:
Rapid breathing (Kussmaul respirations)
Confusion
Lethargy
Headache
Nausea and vomiting
Sleepiness
Shock or death(severe metabolic acidosis)

*most symptoms are caused by the underlying disease

or condition that is causing the metabolic acidosis.
Exams and Tests
Arterial
blood gas
Urine pH
Complete Blood Count
Arterial blood gas – arterial pH below
7.35 confirms metabolic acidosis

Urine pH – can reveal acidity or

alkalinity of urine pH.

Complete blood count – can be done to

help assess possible causes as well
Treatment
Sodium Bicarbonate may be injected
thru I.V. to improve the acidity of the
blood.
Sodium Bicarbonate (baking soda)
Alkalinising Agents
Dialysis therapy
Nursing Priorities
Achieve homeostasis.
Prevent/minimize complications.
Provide information about
condition/prognosis and
treatment needs as appropriate.
Prevention
Eating a balanced diet (low-fat
meats, fruits and vegetables)
1-3 liters of water/day
Keep your life as stress-free as
possible
Consult doctor for a healthy diet and
exercise program