Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MD 4910 NCP I > 4910: C8 Acid-Base Balance > Flashcards

4910: C8 Acid-Base Balance Flashcards

1
Q

acid-base balance

A

Maintenance of homeostasis between acidity and alkalinity within body systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acidemia

A

Condition of excess acid in the blood consistent with a pH < 7.35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

acidosis

A

Conditions that produce excess acid in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

alkalemia

A

Condition of excess base in the blood consistent with a pH > 7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

alkalosis

A

Conditions that produce excess base in the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

anion gap (AG)

A

The difference between unmeasured anions and cations. Is important in distinguishing types of acid-base disorders. Anion gap (AG) = (serum Na⁺) - (serum Cl⁻ + HCO3⁻); normal AG = 12-14 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

electro-neutrality

A

State in which the sum of the charges of the anions equals the sum of the charges of the cations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Henderson-Hallel back equation

A

A formula for calculating the pH of a buffer system such a blood plasma. pH = pKª + [H2CO3] / HCO3⁻]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

hypercapnia

A

The term used to describe an excess of the blood gas carbon dioxide (CO2).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Kussmaul breathing

A

Rapid, deep, and labored breathing commonly seen in people who have ketoacidosis or who are in a diabetic coma; Kussmaul breathing is named for Adolph Kussmaul, the 19th century Dr who first noted it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

metabolic acidosis

A

Condition resulting from either loss of bicarbonate or retention of non-volatile acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

metabolic alkalosis

A

Condition resulting from either retention of bicarbonate or loss of non-volatile acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pK

A

The constant degree of dissociation (the ability of an acid to release its hydrogen ions) for a given solution; this is a constant amount for any given solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

respiratory acidosis

A

Condition resulting from excess acid in the blood secondary to carbon dioxide retention.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

respiratory alkalosis

A

Condition resulting from excess base in the blood secondary to increased carbon dioxide expiration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acid

A

Substance that can donate or give up hydrogen ions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

volatile acids

A

Acids that can be converted to a gaseous form and eliminated by the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

nonvolatile acids

A

Inorganic acids that are formed during metabolism of CHO, PRO, and lipid. The lungs cannot eliminate nonvolatile acids. aka fixed acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

H2CO3

A

Carbonic acid. The most important volatile acid b/c produced in the largest amounts. Dissolves readily in solution to form CO2 + H2O. PaCO2 is used as an indirect measure of this acid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

base

A

Substance that can accept or receive a hydrogen ion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

HCO3⁻

A

Bicarbonate. Predominant base in human acid-base balance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

buffer

A

Substance or group of substances that reacts with either acid or base in order to decrease the effect of acid or base on the pH of a solution.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Normal serum pH range

A

pH 7.35-7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the three systems the body uses to maintain acid-base balance?

A

Chemical buffering. Respiratory regulation of pH. Kidney regulation of pH.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

bicarbonate-carbonic acid buffer system

A

Primary ECF buffer against non-carbonic acid changes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Protein buffer system

A

Primary ICF buffer; also buffers ECF. Proteins accept H⁺, some proteins can release H⁺ if alkalinity increases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hemoglobin buffer system

A

primary buffer against carbonic acid changes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

phosphate buffer system

A

Important urinary buffer; also buffers ICF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

disodium/monosodium phosphate buffer

A

Na2HPO4 + H⁺ ⇋ NaH2PO4 + Na⁺. Buffer system within RBCs and tubules of the kidney.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the most important buffer in blood?

A

Hemoglobin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does hemoglobin buffer the blood?

A

It binds H⁺. As CO2 enters the blood it combines with H2O to form carbonic acid (H2CO3). The carbonic acid dissolves in the blood releasing H⁺, which is taken up by hemoglobin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When acidosis occurs respiratory rate ?

A

increases (hyperventilation) in an attempt to expire more CO2 and normalize pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When alkalosis occurs respiratory rate?

A

decreases (hypoventilation) in an attempt to conserve CO2 and normalize pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In alkalosis the kidney will?

A

Reduce the amount of HCO3⁻ reabsorbed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

In acidosis the kidney will?

A

Increase the secretion of H⁺ and increase the amount of HCO3⁻ reabsorbed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Can the kidney excreted H⁺ & HCO3⁻ at the same time?

A

No. It must use dibasic phosphate and ammonium to buffer acidic urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

NH3

A

Ammonia. A base.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

NH4⁺

A

Ammonium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How is NH3 formed in the kidney?

A

The renal tubular cells form ammonia for Glutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Why is ammonium always excreted in the urine?

A

It can not cross back across the cell membrane, so the H⁺ is trapped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

One-third of H⁺ is excreted as?

A

Phosphoric acid (H2PO4) and sulfuric acid (H2SO4).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What ion moves in the opposite direction of bicarbonate (HCO3⁻).

A

Cl⁻. The electrolytes move in the opposite direction to maintain electro-neutrality.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Normal arterial blood gas (ABG) of pO2, mmHg

A

80-100 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Normal arterial blood gas (ABG) pCO2, mmHg

A

35-45 mmHg

45
Q

Normal arterial blood gas (ABG) HCO3⁻

A

21-28 mEg/L

46
Q

Normal base excess

A

-2.4 - +2.3

47
Q

Anion gap, mEq/L

A

8-16 mEq/L

48
Q

Os saturation %

A

> 95%

48
Q

Uncompensated

A

Accompanied by a change in the pH of the blood

49
Q

Compensated

A

Buffered so that there is no change in the pH of the blood

50
Q

Symptoms of respiratory acidosis

A

Hyperventilation. Restlessness. Apprehension. Lethargy. Muscle twitching. Tremors. Convolutions & eventual coma.

51
Q

Treatment of respiratory acidosis

A

Correct underlying causative condition. Administer oxygen, or mechanical ventilation.

52
Q

Symptoms of respiratory alkalosis

A

pH > 7.45. Lightheadedness. Confusion. Anxiety. Seizures. In acute PaCO2 decreased. In chronic plasma HCO3- is low.

54
Q

Treatment of respiratory alkalosis

A

Correct underlying cause. Oxygen therapy. If cause is psychological CO2 rebreathing can correct symptoms.

55
Q

Common causes on metabolic acidosis

A

Loss of HCO3⁻: systemic or kidney. Chronic kidney disease. Diarrhea. Fistula drainage. Ketoacidosis: DM, alcoholism, starvation. Lactic acidosis - DM, salicylate overdose.

56
Q

Symptoms of metabolic acidosis

A

Kussmaul breathing. Hypotension & dysrhythmias. Lethargy, stupor, eventual coma as pH falls in CSF. Growth failure in children & osteodystrophy in adults due to removal of carbonate from bone in chronic acidosis.

57
Q

Treatment of metabolic acidosis

A

Treat underlying cause. Raise pH slowly to safe level.

58
Q

Common causes of metabolic alkalosis

A

Loss of acid. Vomiting. Nasogastric suctioning. Hypokalemia. Excessive base. Intravenous therapy. Blood transfusion. Antacids. Fluid imbalance.

59
Q

Symptoms of metabolic alkalosis

A

pH > 7.45. Elevated HCO3⁻. K⁺< 98. Signs and symptoms are determined by underlying cause.

60
Q

Treatment of metabolic alkalosis

A

Correct fluid V with KCl⁻, if related to fluid V deficit. Treat underlying cause. If severe use carbonic anhydrase inhibitor to enhance HCO3⁻ excretion.

61
Q

When should a mixed said-base disorder be suspected when examining ABGs?

A

When PaCO2 and HCO3⁻ are not consistant with the measured pH.

62
Q

What is the ratio of base to acid in the body?

A

20:1

63
Q

What is the largest source of acid in the body?

A

Carbonic acid.

64
Q

How is acidity of the body measured?

A

Indirectly through the measurement of PaCO2.

65
Q

What organ primarily regulates CO2 in the body?

A

The lungs.

66
Q

The larges source of base is ?, which is regulated primarily by ?.

A

Bicarbonate (HCO3⁻), the kidneys.

67
Q

Respiratory acidosis is a result of retention of ?

A

CO2. PaCO2 will be increased

68
Q

Respiratory alkalosis is a result of ?

A

Hyperventilation and subsequent decrease in CO2 levels.

69
Q

Metabolic acidosis occurs when there is retention of ?

A

fixed acids, or excessive loss of base.

70
Q

Metabolic alkalosis is a result of excessive loss of

A

fixed acids or retention of bases.

71
Q

What are the volatile acids of the body?

A

Carbonic acid

72
Q

When consumed, which component of foods contributes the most to the production of acids in the body?

A

Proteins

73
Q

What substance of the body has the lowest pH?

A

Gastric juice.

74
Q

What is the primary acid-base buffering system of the ICF.

A

Protein buffer system

75
Q

What organ is responsible for regulation of most fixed / non-volitle acid?

A

Kidney

76
Q

As H+ and HCO3- are electrolytes, which anion will be most affected by acid-base imbalances so as to maintain electroneutrality?

A

Chloride (Cl⁻)

77
Q

Which acid-base disorder is associated with a larger than normal anion gap?

A

Metabolic acidosis

78
Q

In hyperventilation, what would you expect to happen initially to the body’s pH and either the pCO2 or HCO3- concentration?

A

Increases pH, decreases pCO2

79
Q

In respiratory alkalosis, what would you expect to be the body’s compensatory mechanism?

A

The kidney will excrete more HCO3⁻

80
Q

Which acid-base disorder is associated with uncontrolled diabetes mellitus or starvation adaptation?

A

Metabolic acidosis.

81
Q

Which acid-base disorder is associated with hyperventilation, such as might occur after intense exercise or an anxiety episode?

A

Respiratory alkalosis

82
Q

In metabolic acidosis, what would you expect to happen initially to the body’s pH and either the pCO2 or HCO3- concentration?

A

Decreased pH, decreased HCO3⁻

83
Q

In metabolic acidosis, what would you expect to be the body’s compensatory mechanism?

A

The lungs will expire more pCO2.

84
Q

In metabolic alkalosis, what would you expect to be the body’s compensatory mechanism?

A

The lungs will retain more CO2.

85
Q

Bicarbonate appears in what form in the ECF?

A

NaHCO3⁻. but can also be combined with K⁺, or Mg⁺

86
Q

pH in the body is primarily a ratio of?

A

H2CO3:HCO3⁻. 1 part carbonic acid to 20 parts bicarbonate.

87
Q

Isohydric principle

A

If [H⁺] is altered, the base to acid ratio of all buffer systems is altered. Therefore, the status of all buffer systems can reevaluated using the ration of HCO3:CO2.

88
Q

Normal acid base balance is maintained by?

A

Chemical buffering. Respiratory control of CO2. Renal control of HCO3⁻.

89
Q

Strength of chemical buffering systems?

A

Strength is related to ready availability of HCO3⁻, both components can be regulated, and HCO3⁻ is regenerated by kidney.

90
Q

Minor buffering systems in the body

A

PO4. Proteins

91
Q

How do lungs respond to changes in [H⁺]

A

By changing rate or depth (or both) of respirations.

92
Q

Carbonic anhydrase

A

Enzyme in kidney responsible for conversion of HCO3⁻ to H2CO3 to CO2 & H2O and conversion of CO2 back to HCO3⁻.

93
Q

What is kidneys main adaptive response for an increased acid load?

A

In order for kidneys to secrete H⁺, it combines with NH3 to form NH4 and thus the urine pH is not affected.

94
Q

Symptoms of acute respiratory acidosis

A

weakness, respiratory distress, anxiety, confusion.

95
Q

As compensation of respiratory acidosis occurs what happens in the body?

A

pH returns to normal, PaCO2 and HCO3 are increased.

96
Q

Therapeutic interventions for Respiratory acidosis?

A

Bronchodilators. Mucolytics. Respiratory therapy. O2 therapy. Mechanical ventilation. Hydration.

97
Q

Compensatory response for respiratory alkalosis

A

kidneys retain more H⁺ & excrete more HCO3.

98
Q

Therapeutic intervention for respiratory alkalosis

A

Manage underlying cause: sedatives, anti-anxiety agents for hyperventilation related anxiety.

99
Q

What is the impact of respiratory alkalosis on K, Ca and Cl⁻

A

K & Ca maybe decreased. Cl⁻ maybe increased due to exchange with HCO3⁻

100
Q

Symptoms of metabolic acidosis

A

Tachypnea (Kussmaul breathing). Hypotension. Cold & clammy skin. Coma.

101
Q

physiological response to metabolic acidosis

A

The kidneys conserve HCO3⁻. Compensatory response = deepened respirations to increase release of CO2.

102
Q

What is the primary cause of metabolic alkalosis?

A

Loss of HCl.

103
Q

Physiological response to metabolic alkalosis

A

Kidneys excrete HCO3 & retain H⁺. compensatory - respiration is suppressed - CO2 is retained.

104
Q

Steps to determine acid/base imbalance

A
  1. evaluate pH. 2. Assess PaCO2 3. Assess HCO3 4. Is compensation present? 5. Determine the primary imbalance: always go with pH first, then check the most deviant component: respiratory vs. metabolic.
105
Q

Metabolic acidosis all arrow point?

A

down: pH, HCO3⁻, PCO2

106
Q

metabolic alkalosis all arrows point

A

up

107
Q

respiratory acidosis arrows point

A

down, up, up. pH, HCO3⁻, PCO2

108
Q

Respiratory alkalosis arrows point

A

up, down, down. pH, HCO3⁻, PCO2

MD 4910 NCP I (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions