6.5 Compensating for Respiratory and Metabolic Disturbances

Question 1

Two rules for compensation?

Answer 1

Compensation will never get me back exactly to normal

compensation must be made by other system

Question 2

Why is the distal convoluted tubule and collecting duct important for respiratory acid/alkalosis?

Answer 2

Cells here are able to secrete HCO3 or H+ as conditions demand

Question 3

If acidotic the DCT/CD cells will do what?

Answer 3

Move H+ ion to urine and take HCO3 and move it back to the blood, compensating for respiratory acidosis (plasma HCO3 levels will increase)

Question 4

If respiratory alkalosis the DCT/CD cells will do what?

Answer 4

HCO3 will go to the urine and the H+ will go to the blood, so the HCO3 plasma levels will be lower and the pH will become more acidic

Question 5

What is the equation for acute respiratory acidosis to calculate the expected [HCO3]?

Answer 5

Expected [HCO3] = 24 + ((PaCO2-40)/10)

Question 6

What is the equation for chronic respiratory acidosis to calculate the expected HCO3 that will be compensating?

Answer 6

Expected [HCO3] = 24 + 4x((PaCO2-40)/10)

Question 7

What is the equation for acute respiratory alkalosis to calculate the expected HCO3 (will decrease)?

Answer 7

Expected HCO3 = 24 - 2((40 - PaCO2)/10)

Question 8

What is the equation for CHRONIC respiratory alkalosis to calculate the expected HCO3?

Answer 8

HCO3= 24- 5((40-PaCO2)/10)

Question 9

What is the equation for metabolic acidosis to calculate expected PaCO2?

Answer 9

(1.5[HCO3]+8) +/- 2

if between the certain range, the determine the compensation is adequate

Question 10

What is the equation for metabolic alkalosis to calculate expected change PaCO2 to determine if respiratory compensation is adequate?

Answer 10

(0.5 to 1.0) x changeHCO3

if between this range, compensation is adequate

Question 11

The anion gap equation is base on the rule that positive and negatively charged anions balance themselves out. What is the equation?

Answer 11

Anion gap= [Na+] - ([Cl-]+[HCO3-])

Question 12

What is the normal anion gap?

Answer 12

equal to or less than 16

Question 13

Osmolarity of blood can be measured how?

Remember normal osmolarity is 290mOsmoles/L

Answer 13

Osmolarity = (2xserumNa) + (BUN/2.8) + (glucose/18)