A condition that transpires when the
lungs can’t remove all the carbon dioxide the body manufactures is known as
respiratory acidosis (Epstein, 2001). This makes body fluids, mainly the
blood, to become too acidic. Also, it is an acid-base balance disturbance due
to alveolar hypoventilation. Respiratory acidosis PaCO2 normal reference
range is 35-45 mm Hg (Epstein, 2001). The normal blood pH for respiratory
acidosis is 7.35 and 7.45. The causes for respiratory acidosis are diseases
within in the lung tissue (pulmonary fibrosis), sleep apnea, heavy pain
medications, and acute obesity. Its symptoms are short of breath, confusion,
and lethargy (Hadjiliadis, 2016).  The compensatory answer to respiratory
acidosis is a raise in bicarbonate levels. He kidneys hold on to bicarbonate. Respiratory
acidosis can be diagnosed by chest x-ray, CT scan, or pulmonary function test.
There are a few treatments for respiratory acidosis. A CPAP which is a
noninvasive positive pressure ventilation may be prescribes (Hadjiliadis, 2016). Also, drugs to reverse some types of
airway obstruction, oxygen, and treatments that help to stop smoking are also

Respiratory alkalosis condition
pronounced by a low level of carbon in the blood due to breathing inordinately.
The causes of this condition are anxiety, hyperventilation, pregnancy and fever (Hadjiliadis,
2016).  Lung diseases that can lead to shortness of breath
may also cause respiratory alkalosis (pulmonary embolism or asthma). The
symptoms may consist of being light headed, numbness of the hands and feet, and
dizziness. TO determine the pH for respiratory alkalosis is pH > 7.45. The
normal range is 7.35-7.45.  Direct
activity to the respiratory centre can causes respiratory alkalosis.  The source of respiratory alkalosis is
hyperventilation. Hyperventilation is when someone breathes rapidly or deeply.
The causes of this are asthma, chronic obstructive pulmonary disease,
pregnancy, and drug use (Acid Base
Physiology, n.d.).
In respiratory alkalosis changes within the physicochemical equilibrium occur
because of lowered pCO2, results in modest decrease in HCO3. There is not
enough time for the kidneys to answer, therefore this is the only change in
respiratory alkalosis. The overall response is a decrease in bicarbonate
levels. When anxiety is the overall cause of the condition, using a mask so you
can re-breathe carbon dioxide.

Metabolic acidosis is when there is
a clinic disturbance distinguished by an increase in plasma acidity (Quinn, 2017).  One of the causes of metabolic acidosis is
when the kidneys aren’t removing enough acid from the body. Three types of
metabolic acidosis are diabetic acidosis, hyperchloremic acidosis, and lactic
acidosis.  Diabetic ketoacidosis is a
consequential complication of diabetes. This is a result of the body producing
high levels of blood acid ketones and not being able to produce enough insulin.
Hyperchloremic acidosis is present when there is a decrease in plasma
bicarbonate concentration and an increase in plasma chloride concentration.
Lactic acidosis is present when there is a buildup if lactate in the body. This
results in extremely low pH in the blood. Kidney diseases, poisoning by
methanol and severe dehydration can cause metabolic acidosis. The normal HCO3
range is 22-26mmol/L. To determine the metabolic component in metabolic
acidosis you use the formula <22mmol/L. The pH for metabolic acidosis is 7.35 or lower. The body's response to metabolic acidosis is foreseeable. Ventilation increases to blow off CO2. This decreases the amount of acid in the blood. Frequent treatments for metabolic acidosis are insulin if you have DKA which can you in a coma, detoxification from drug or alcohol poisoning, iv fluids, and sodium bicarbonate administered through an iv. When your body loses so much acid or gains to much base, this is known as metabolic alkalosis. Attributed to this is adrenal disease, antacids, laxatives, and alcohol abuse.   Loss of hydrogen ions, contraction alkalosis, and shift of hydrogen ions into the intracellular space can generate metabolic alkalosis. Hydrogen ions can be lost through the GI tract or kidneys. Shifting of hydrogen ions into the intracellular space overall develops with hypokalemia. Handing tremoring, muscles spasms for an excessive amount of time, muscle twitching are signs of metabolic alkalosis. The pH level is 7.45 or higher, also HCO3>26 mmol/L. In
order to retain CO2 we have to hyperventilate. However, stimulation of brain
chemoreceptors with an elevated PaCO2 dulls the hypoventilation required to
correct the pH. Basically, ventilation decreases when holding on to CO2. To
treat metabolic alkalosis, you need to correct the blood pH. You can undergo
dialysis, and get iv fluids.

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Older age might compromise the
acid-base balance process. One of the major organs, the kidney, has a specific
structural and functional phenotypic change that happens with aging. Older age
people have a decrease in renal in renal plasma flow and glomerular filtration
then of a younger individual. At age 40 the decrease or decline starts. On
standard occasions, elderly people are able to maintain an electrolyte balance,
however, in dangerous situations that can be gone. This makes them subject to
hypernatremia, hyponatremia, and volume depletion. Plasma sodium is the most
common electrolyte disturbance occurring in elderly people.  Furthermore, a decline in urinary
concentration ability and thirst can contribute to dehydration which is common
in elderly patients. 


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