Take a nutritional history from your client to assess for malnutrition, starvation and severe diarrhea. Assess him further by performing a physical assessment on his heart for irregular heart beats and checking for low blood pressure and skin temperature. Assess his respiratory pattern and check his level of consciousness. Review his medical records for laboratory tests that show electrolyte imbalances such as hyperkalemia and abnormal pH readings.
Metabolic acidosis occurs when the blood has a high acid content. It can be caused by severe diarrhea, kidney disease, diabetic ketoacidosis or starvation. Symptoms of metabolic acidosis include loss of appetite, nausea, vomiting, stomach pain, irregular heart beats, increased respiratory rate, warm flushed skin and coma.
Organize the data you collected during your assessment and identify your priority nursing assessments. These are the most troubling signs, symptoms and effects of metabolic acidosis displayed by your patient. Next, write down your nursing diagnoses based on your priority nursing assessments. A nursing diagnosis for metabolic acidosis could be decreased cardiac output related to dysrhythmias from hyperkalemia.
Write down your goals or expected outcomes for your patient based on the nursing diagnoses you chose.Your expected outcome could be that the patient will show adequate cardiac output as evidenced by her vital signs which are blood pressure, pulse rate and heart rhythm being within her normal limits.
Write down the nursing interventions that you will implement to meet your expected outcomes. Nursing interventions for metabolic acidosis include administering sodium bicarbonate , intravenous fluids and medications as ordered, monitoring laboratory results for serum electrolytes and monitoring vital signs.
Implement your nursing interventions and observe your patient's response to them. Determine if your expected outcomes were met by checking to see if your patient's blood pressure, pulse rate and heart rate remained within his normal limit. If they were not met, reassess your patient and change your interventions accordingly.
- "Nursing Diagnosis Handbook"; Betty J. Ackley RN and Gail B. Ladwig CHTP ; 2008
- "Fundamentals of Nursing" ; Patricia A. Potter FAAN and Anne Griffin Perry FAAN; 2009
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