(^422) Medical-Surgical Nursing Demystified
ACID BASE BALANCE
Maintaining acid-base balance will keep the pH level within the normal range of
7.35 to 7.45. The lungs and the kidneys are integral in maintaining the normal
acid-base balance. The body constantly monitors the pH level and makes adjust-
ments in an attempt to correct any abnormalities. pHCO 3 is regulated by the kid-
neys. pCO 2 is regulated by the lungs. If the patient develops acidosis there will be
a low pH and either a drop in pHCO 3 (metabolic) or a rise in pCO 2 (respiratory).
If the patient develops alkalosis there will be an increase in pH and either an
increase in pHCO 3 (metabolic) or a drop in pCO 2 (respiratory). In an attempt to
maintain as normal an internal environment as possible, the body will attempt
to compensate for the changes that are occurring. The lungs are able to correct
much more rapidly than the kidneys.
Just the Facts
Hyponatremia
WHAT WENT WRONG?
Hyponatremia is an abnormally low amount of sodium in the blood. Low levels of
sodium may be due to loss of sodium from the body, movement of sodium from the
blood to other spaces, or dilution of sodium concentration within the plasma. Some
causes include increased excretion or abnormal excretion of sodium, water imbal-
ance, hormonal imbalance (such as excess ADH), ecstasy (methylenedioxymethy-
lamphetamine) use, hypothyroidism,renal failure, diuretics, diarrhea, vomiting, and
wound drainage.PROGNOSIS
Identification and correction of the underlying cause is important in treatment of
hyponatremia. Water restriction of all patients with hyponatremia will help to pre-
vent further dilution of the plasma concentration of sodium. Seizure and death may
occur if the electrolyte imbalance is not identified and corrected.HALLMARK SIGNS AND SYMPTOMS
- Hypotension, especially orthostatic (with position changes—from lying to
sitting) due to decrease in cardiac output in setting of hypovolemia
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