4.3 - Acid-Base Imbalances

Question 1

4 Types of Acid-Base Imbalances

Answer 1

1) Respiratory Acidosis
- too much Co2 = too much acid in body

2) Respiratory Alkalosis
- too little Co2 = not enough acid

3) Metabolic Acidosis
- too much acid
- not enough base

4) Metabolic Alkalosis
- too much base

Question 2

pH

Answer 2

Acidosis < 7.35

Normal: 7.35-7.45

Alkalosis > 7.45

Question 3

Role of Kidneys

Answer 3

During Acidosis
- low pH = ↑ H in blood
- kidneys ↑ H+ secretion into tubules
- H+ forms compounds to be excreted by urine to ↓ H

During Alkalosis
- blood pH is high bc of ↓ H+
- kidneys ↑ bicarbonate secretion into tubules
- bicarbonate gets excreted in urine so urine is more alkaline

Question 4

Acidosis VS. Alkalosis

Answer 4

Acidosis
- excess H outside of cell (in blood)
- H moves into cell to balance pH
- bc H moves into the cell, K moves out of cell to balance
- increases serum K (in blood)
- HYPERKALEMIA

Alkalosis
- H inside cell
- H moves into blood to balance pH
- bc H moves into blood, K moves into cell
- decreased serum K (less K in blood)
- HYPOKALEMIA

Question 5

Resp Acidosis (low pH and high Co2)

Answer 5

Cause
- deficit in lung function that increases CO2
-↑ CO2 = ↑ bicarbonate = ↑ H+ = ↓ pH

Structural Changes
- kidneys increase bicarbonate reabsorption (to buffer H ions)
- lung fibrosis

Significance
- shallow, slow RR
- dysryhtmias
- ↓ BP
- lethargy, confusion, headache

Question 6

Resp Alkalosis (high pH and low Co2)

Answer 6

Cause
- overventilation of lungs
- ↓CO2 = ↓ bicarbonate = ↓ H = ↑pH

Significance
- hyperventilation (breathing out too much CO2)
- ↓ BP
- dysryhtmias
- muscle cramps in hands)
- confusion, dizziness,

Question 7

Metabolic Acidosis (low pH and low bicarbonate)

Answer 7

Causes
1) Loss of too much base
2) Retention of to much acid

Patho
↑ acid OR ↓ bicarbonate =↑ H = ↓ pH

Structural Changes
- resp system compensates by hyperventilation (reducing CO2 which reduced acid)
- muscle wasting (acidic environment increases protein breakdown

Significance
- ↑ RR and depth: breathing faster means more CO2 exhaled
- confusion , lethargy
- electrolyte imbalances

Question 8

Metabolic Alkalosis (high pH and high bicarbonate)

Answer 8

Causes
1) Loss of too much acid
2) Retention of too much base

Patho
-↑ bicarbonate OR ↓ acid = ↓ H = ↑ pH

Structural Changes
- hypoventilation: to retain CO2
- hypokalemia

Significance
- ↓ RR (to retain CO2) - bc slower breathing reduced CO2 exhaled
-lethargy, confusion, tremors, twitching