Aswe get older the presence of disease in our body increase.

  We have a hard time maintain fluidelectrolyte and an acid-base balance. Older adults are taking an increase number of medication, suffer fromhigh blood pressure, and heart disease. They are at risk of having lung disease and kidney disease.  With older adults their risk factors increasewhich includes diabetes, obesity, infections, dementia, and cancer.Metabolicacidosis is a decrease in HCO3- due to an increase in acid or a loss ofHCO3-.  There are three reasons that theblood level of HCO3- may be lower.

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 First, the actual loss of HCO3-, second, the accumulation of an acidother than carbonic acid, and third, the failure of the kidneys.  Sometimes the chemical balance of acids andbases gets thrown off and your body begins to make too much acid or maybe itisn’t getting rid of enough acid or doesn’t have enough base to offset a normalamount of acid. Some causes for metabolic acidosis are alcoholic ketoacidosis,diabetic ketoacidosis, kidney failure, lactic acidosis, toxins-overdose ofsalicylates, renal tubular acidosis, hyperchloremic acidosis which includesevere diarrhea, laxative abuse, or kidney problems.  If pH is in normal range than HCO3- will below and the compensation will be complete. Treatment includes detoxification, insulin, IV fluids, and Sodiumbicarbonate, by IV.Metabolicalkalosis is an increase in HCO3- and occurs because of a loss of H+.  If there is an increase in pH then there isno increase in compensation.

  The pHwould increase if there is a non-respiratory loss of acid.  Some causes of metabolic alkalosis areprolonged vomiting, diuretics, adrenal disease, a large loss of potassium orsodium in a short amount of time, antacids, accidental ingestion of HCO3-,which could be found in baking sodium, laxatives, alcohol abuse, severedehydration, disease that cause loss of potassium, administration of HCO3-,ingestion of alkali.  If there is anincrease in HCO3- then it is due to the loss of acid or gain of HCO3-.  There will be a normal pH if compensation iscompleted.  There will also be a highHCO3-.  One treatment for metabolicalkalosis is giving fluid solutions to correct deficiencies.

Respiratoryacidosis occurs when the lung can’t remove enough carbon dioxide.  It’s an increase in Pco2 and a decreased inpH if there is no compensation.  Itbecomes acidic when the excess carbon dioxide causes the pH to decrease.  When the lung can’t remove enough carbondioxide it could be caused by a decrease in respiratory rate.  For compensation to be complete there will bean increase in excretion of H+ and an increased reabsorption of HCO3-.  PH will then be in normal range.

  Some cause of respiratory acidosis isHypoventilation due to emphysema, pulmonary edema, trauma to respiratorycenter, airway obstructions, or dysfunction of muscles of respiration, asthma,COPD, pneumonia, and sleep apnea, Treatment for respiratory acidosis includesventilation therapy and intravenous administration of HCO3-.Respiratoryalkalosis causes a decreased in systemic arterial blood Pco2 and an increasedpH if there is no compensation.  When thelevel of carbon dioxide and oxygen are not balanced or if there is not enoughcarbon dioxide in your bloodstream that is when respiratory alkalosisoccurs.  If the pH of the blood rises itwill become alkaline.  Pco2 will be lowand the pH will nor if the compensation is completed.  Some causes of respiratory alkalosis rarehyperventilation, high fever, lack of oxygen, pneumonia, embolism, exercise,central nervous system tumor, trauma, infection, salicylate poisoning, highaltitudes, liver disease, or lung disease.

  A treatment for respiratory alkalosis is to inhale and exhale into apaper bag.Respiratoryis a change in Pco2 and metabolic is a change in HCO3-.  There are two categories of acid-basedisorders.  Respiratory, which isaffected by the breathing or some type of lung disease and metabolic whichaffects the kidney.  Compensation occurswhen the valve is in the normal range. When the valve is not in normal range then no compensation will occur.Thenormal pH range is between 7.35 and 7.

45. Alkalosis is when the blood pH is higher than 7.45 and acidosis is whenthe blood pH is below 7:35.  An acid-baseimbalance could be caused by pH, a concentration of HCO3-, and Pco2.

  The change in pH can be caused by the Pco2 orHCO3- being out of normal range.  Ifthere is an imbalance in the pH it could be caused by a base which is an excessof acid or alkali or the imbalance could be caused by some other condition ordisease.  You have to maintain a normalblood pH in order to process the right amount of oxygen to the tissue.  Inmy paper, I will discuss Alkalosis and Acidosis.  I will define respiratory alkalosis,respiratory acidosis, metabolic alkalosis, and metabolic acidosis.  Identify at least three or more common causesfor each condition.  Describe thecompensator mechanism including whether the kidneys or the lung assist.  Describe the treatment mechanisms for eachcondition and how older age compromise the acid-base balance process.


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