CHAPTER 11 Fluids and Electrolytes^439
- Tachycardia early in acidosis; later, cardiac electrical conduction slows, caus-
ing bradycardia and increasing risk for heart block or arrhythmia - Hypotension due to vasodilation
- Rapid, deep breathing (hyperventilation) as body attempts to compensate
INTERPRETING TEST RESULTS
- Arterial blood gas showing pH < 7.35 and bicarbonate < 22 mEq/L, normal
PaCO 2. - Ketones in urine possible.
- Potassium level elevated.
- Chloride level normal or elevated.
TREATMENT
- Administer intravenous fluids for hydration as necessary.
- Monitor arterial blood gas levels.
- Administer supplemental oxygen as necessary.
- Administer bicarbonate if bicarbonate levels are low.
- Correct the underlying condition that is causing the imbalance.
- Administer insulin and fluids in diabetic ketoacidosis.
- Mechanical ventilation if necessary.
- Hemodialysis if necessary to restore normal balance in system or remove
offending substance.
NURSING DIAGNOSES
- Disturbed thought processes
- Ineffective breathing pattern
NURSING INTERVENTION
- Monitor intake and output.
- Monitor vital signs for changes.