Acid-base disorders can be differentiated based on whether they have metabolic or respiratory causes. There are four main acid-base abnormalities: metabolic acidosis, metabolic alkalosis, respiratory acidosis and respiratory alkalosis. It is important to characterize the type of acid-base disorder because this will dictate the treatment and response, or “compensation” mechanism enacted by the body. When an acid-base imbalance occurs, the body attempts to restore the normal pH by developing an opposite acid-base imbalance to offset the effects of the primary disorder, a response known as compensation.

   Compensation does not always occur; and when it does, it is not completely successful (i.e., does not result in a pH of 7.4). The pH level still reflects the underlying primary disorder. Clinicians must distinguish between primary disturbances and compensatory responses because treatment always is directed toward the primary acid-base disturbance and its underlying cause. As the primary disturbance is treated, the compensatory response corrects itself. Predictive values for compensatory responses are available to differentiate between primary acid-base imbalances and compensatory responses.

   Regardless of the disorder, the Health Guardian directs the treatment at the underlying cause and uses supporting information from the medical history, current clinical condition, medications, laboratory values, intake and output records, and physical examination to determine the cause of any Acid-Base imbalance. The Health Guardian and other primary team members play an important role in understanding the physiologic process and how it relates to regulation of an acid-base balance. Adjustments to the nutrition care plan related to acid-base balance can help restore cell physiology and prevent future pathologies.