Metabolic acidosis (primary base bicarbonate [HCO3] deficiency) reflects an excess of acid (hydrogen) and a deficit of base (bicarbonate) resulting from acid overproduction, loss of intestinal bicarbonate, inadequate conservation of bicarbonate, and excretion of acid, or anaerobic metabolism.

Metabolic alkalosis is characterized by a high pH (loss of hydrogen ions) and high plasma bicarbonate caused by excessive intake of sodium bicarbonate, loss of gastric/intestinal acid, renal excretion of hydrogen and chloride, prolonged hypercalcemia, hypokalemia, and hyperaldosteronism.

Respiratory alkalosis is a loss of carbon dioxide (Pco2 <>2CO3) due to a marked increase in the rate of respirations. Nursing care plans for respiratory alkalosis can be found here.

Respiratory acidosis, an elevation in the PaCO2 level), is caused by hypoventilation with reslutant excess carbonic acid. Here’s a nursing care plan for Respiratory Acidosis.