The in-depth examination of the acid-base balance is a fundamental concept in promoting critical assessment of the patients and recognizing the imbalances influence on their overall wellbeing. An appropriate balance between acid and base in the human body is crucial for “maintaining homeostasis and optimal cellular function” (Straight Nursing, 2019, para. 1). More specifically, the normal range for a serum pH level is 7.35 to 7.45. When the serum has an excess of acid, the pH number is low and, vice versa, the excess of the base in blood makes the pH number rise. Understanding the causes of acidosis and alkalosis concepts and their different types is crucial for the future of nurse practitioners in defining the underlying condition or disease of the patient.
Defining the Issue
Acidosis and alkalosis refer to the arterial blood gases (ABGs), a laboratory test developed to evaluate respiratory status, metabolic status, and acid-base balance. The test is implemented by measuring the acidity (pH) and levels of serum oxygen and carbon dioxide (Walsh & Hurst, 2017). Interpretation of arterial blood gases is a critical step to determine whether the patient is experiencing respiratory acidosis/alkalosis or metabolic acidosis/alkalosis. The test also helps to define whether the body initiated compensatory mechanisms to restore a neutral level of pH. It is also important to note that mortality is associated more common in the circumstances with mixed metabolic acidosis and respiratory alkalosis and mixed metabolic and respiratory acidosis.
The acid-base imbalances encompass the following types of the analyzed conditions, including metabolic acidosis and alkalosis and respiratory acidosis and alkalosis. The acid-base balance is regulated by three systems, such as the” buffer system (metabolic), kidneys (metabolic), and the lungs (respiratory)” (Mohammed & Abdelatief, 2016) (Fig. 1). Metabolic acidosis results from any nonpulmonary condition that promotes an excess of acids in the blood. Metabolic alkalosis is caused by any nonpulmonary condition that leads to an excess of bases instead. Metabolic alkalosis can also result from prolonged vomiting, hyperaldosteronism, and diuretic therapy (Walsh & Hurst, 2017). Respiratory acidosis is a pH level imbalance caused by alveolar hypoventilation and an accumulation of carbon dioxide and can be acute or chronic. Respiratory alkalosis results from the excessive decrease of carbon dioxide through hyperventilation (Fig. 2). It is considered the most commonly occurring acid-base imbalance among the patients.
Implications for Nursing
The normal pH level of blood is essential for the body systems to maintain proper functioning. The particular mechanisms are in a position to ensure a state of acid-base balance within the blood at all times. Therefore, it is crucial to understand within a nursing practice that considerable modifications from this optimal range might interfere with cellular functioning and, ultimately, death, if not treated accordingly. Mohammed & Abdelatief (2016) state that nurses must recognize the case when a patient is not able to retain such balance and, thus, should know how to intervene appropriately (Fig. 3).
Conclusion
Acid-base balance reflects the pH level, which is strongly linked to the health problems that make the body too acidic or too alkaline and facilitate certain health conditions and emergency medical assistance. The compensatory mechanisms and buffering help maintain the pH level within an optimal range in normal conditions. However, a significant number of severe conditions and illnesses are closely intertwined with the body’s pH control and, thus, cause the individual’s blood pH to transcend the healthy limits. The proper balance of both the respiratory and metabolic systems is important for preventing and compensating any abnormalities.
References
Mohammed, H. M., & Abdelatief, D. A. (2016). Easy blood gas analysis: Implications for nursing. Egyptian Journal of Chest Diseases and Tuberculosis, 65(1), 369–376.
Understanding acid-base balance (2019). Straight Nursing. Web.
Walsh, K., & Hurst, A. (2017). Arterial blood gases: Interpreting results. Nursing Practice & Skill, Cinahl Information Systems, 1–8.