The purpose of this assignment is to evaluate the learners’ understanding and critical thinking skills in discussing the important aspects related to the pathophysiologic changes in acid-base...

Running head: Acid-base balance
Acid-base balance
Acid-base balance
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Contents
Introduction    2
Pathophysiologic changes in acid-base imbalances of an adult patient with respiratory distress    2
Complications    6
Clinical manifestations, diagnostic criteria, the treatment, medical management and complications of acid-base imbalances    7
Aetiology    7
Clinical manifestations,    8
Respiratory Acidosis immediate Treatment & Management    8
Respiratory acidosis diagnosed    9
Treating respiratory acidosis    9
Conclusion    11
Introduction
COPD means Chronic obstructive pulmonary disease is one of the biggest public healthcare problem. The prevalence varies by country, gender and age. According to epidemiological data, 2020 projections indicate that COPD is a third leading cause for deaths in the world and the 5th leading cause for disability. Approximately 20% of patients with COPD need to enter in general hospitals and intensive or emergency respiratory units for an acute episode, resulting in increased use of increased costs and medical resources. Although in general prognosis of COPD patients has recently improved, mortality remains high moreover the acid-base disorders that occur in these subjects may affect outcomes. This study focus on how respiratory acidosis (acid-base) causes in COPD patients. This study includes the pathophysiologic changes in acid-base imbalances of an adult patient with respiratory distress. This study includes the discussion about the disorder of acid-base, the aetiology, clinical manifestations, diagnostic criteria, immediate treatment as well as the complications if there is a delayed in medical and nursing management.
Pathophysiologic changes in acid-base imbalances of an adult patient with respiratory distress
The main complication of patients with COPD is the stable hypercapnia development. In healthy subjects, approximately 16,000-20,000 mmol every day of carbon dioxide is produced, which is derived from the oxidation of carbonaceous nutrients. Under normal conditions, lung ventilation can eliminate the production of CO2. However, changes in respiratory exchange in the late stages of COPD lead to retention of CO2 (Al-Jaghbeer, & Kellum, 2014). CO2 is hydrated to form carbonic acid, which is then dissociated from hydrogen ions in patient’s body fluid according to the following equation:
CO2+ H2O= H 2 CO 3 + - HCO 3 + H +.
Therefore, the consequences of hypercapnia caused by changes in gas exchange in patients with COPD are mainly due to the increase in H + concentration plus the development of the respiratory acidosis, furthermore known as hypercapnia. As per the traditional technique of evaluating the acid-base state, an equation of Henderson-Hasselbach represents a relationship between the pH (the logarithm of the reverse H+ concentration), the concentration of bicarbonate ions (-HCO3 ) plus the partial CO2 pressure (pCO 2 ): pH = 6.1 + Login - HCO 3 / 0.03pCO2. (2)
Obviously, the pH and hydrogen ion concentrations are severely determined by a bicarbonate and pCO 2 ratios, not their respective values. Thus, the change in the pH can also be determined with the original alteration of the molecule of the equation, i.e., bicarbonate or denominator, i.e., pCO2 (respiratory disorder). In either case, the compensation mechanism is activated to determine a consensus change of other factors to simply keep the ratio as continuous as much possible and to minimize the changes in the pH. Extent of such compensatory changes depends to a large extent on the extent of the major changes and might be predicted to several extents (predictive compensatory responses). Thus, compensation for respiratory acidosis includes a secondary boost in the bicarbonate concentration, plus arterial blood gases analysis is completely characterized by a decrease in pH, an increase in pCO2 (initial change), and an increase in bicarbonate levels (Al-Jaghbeer, & Kellum, 2014).
Pathophysiology changes in the acid-base imbalance of adult patients with respiratory problems, due to the incidence of an adult patient with respiratory illness, not only the acid-base disorder in COPD patients. The presence of comorbidities and the effects of certain medicines for the treatment of COPD patients create different conditions. These types of conditions are described as mixed acidosis disorders. There are major clinical conditions due to the mixed acidosis disorders. For example, cardiovascular failure, acute lung edema, kidney failure moreover the onset of the sepsis and severe hypoxia is a common reason for metabolism. Abuse of kidney stones with hypercapia volume reduction, hypochlamia and steroid use is the most common component of metabolic algae. Macalkolic alkalocease can also be caused by highly CO2 conclusions in patients with mechanical ventilation. In this case, kidneys were not able to remove hydrogen carbonate more quickly after melting CO2, however some authors said that cell trafficking may have "memory" of pre-existing condition and for some time this hydrogen carbonate repair may continue. Both of them can be together with respiratory acidosis due to metabolic acidosis and metabolic alkalosis. This can lead to clinical conditions, for example, those who are treated with heart disease in high-dose of kidney or those who have kidney failure, vomiting as well as severe hypoxia and reduce the number of external cells. In this case, although changing the final pH depends on the amount of acid or alkaline product, the metabolic basis and the production and removal of inorganic acid will change. There are some systematic studies of acid-base disorder in COPD patients, but one third of these patients have many diseases related to respiratory acidosis - the most common disease metabolism is alkaline. Mixed acid-base disorders presence collects clinical pathophysiology as well as creates problems in diagnosis along with treatment (Bruno, & Valenti, 2012).
Respiratory alkalosis is a disorder of acid-base balance which is caused by alveolar hyperventilation. Alveolar hyperventilation reduces partial pressure of the arterial carbon dioxide. On the other hand, the increase in bicarbonate ratio increases to PaCO2 by increasing the...