ABG

Question 1

What is a buffer?

Answer 1

a chemical system that prevents radical change in fluid pH by dampening the change in hydrogen ion concentration when there is excess acid or base

Question 2

What is normal pH that they body depends on?

Answer 2

7.35 - 7.45 but the best possible pH is 7.4

Question 3

What is pH?

Answer 3

concentration of hydrogen ions

Question 4

pH and hydrogen are…

Answer 4

inversely related

As hydrogen concentration goes up, pH goes down

Question 5

Why is acid base balance necessary?

Answer 5

To maintain homeostasis
All cells depend on it
Drastic fluctuations either acidic or alcalotic can lead to life-threatening disorders

Question 6

How does the body maintain a pH between 7.35-7.45

Answer 6

Hemeostatic mechanisms and respiratory system like exhaling CO2, buffer system and the renal system

Question 7

Low pH

Answer 7

Acidic, less than 7.35, increase in hydrogen ions

Question 8

High pH

Answer 8

alkaline, more than 7.45, decreases in hydrogen irons

Question 9

Acidosis

Answer 9

blood pH below 7.35. more acid or less base

Question 10

Alkalosis

Answer 10

blood pH above 7.45, less acid or more base

Question 11

a base will…

Answer 11

neutralize an acid and promote the excretion of acid

Question 12

What are some examples of health problems that lead to acid/base imbalance?

Answer 12

Diabetes, COPD, kidney disease

Question 13

Is an acid/base imbalance a disease?

Answer 13

No, it is a manifestation of an underlying health problem and should be considered in any patient with a serious illness

Question 14

An acid..

Answer 14

fors hydrogen ions in solution

Question 15

How do the lung help maintain normal pH?

Answer 15

The lungs blow off or retain CO2

Question 16

How does the buffer system maintain normal pH?

Answer 16

CO2 is generated in the tissues and transported in plasma as bicarb, the RBC’s hemoglobin buffers hydrogen

Question 17

How do the kidneys help maintain normal pH?

Answer 17

Kidney reabsorb filtered bicarb in the proximal tubules and generate new bicarb in the distal tubules, where there is a net secretion of hydrogen ion
Kidneys also excrete H+

Question 18

Kussmauls respirations are

Answer 18

deep rapid breathing

Question 19

Buffers

Answer 19

1. first life of defense
2. chemical actions
3. Change acids, or neutralize acids
4. Can also release H+ if needed

Question 20

Respiratory system

Answer 20

Changing the level of CO2

• hypercarbic drive
• hypoxic drive

Question 21

Renal

Answer 21

Change level of HCO3

-kidneys regulate H+ ions or bicarb ions

Question 22

Hypoventilation

Answer 22

acidosis

Question 23

CNS depression in both acidosis and alkalosis

Answer 23

HA, weakness, leathery, confusion, can lead to coma and death

Question 24

Alkalosis and electrolytes

Answer 24

hypocalcemia –> muscles cramping, numbness, tetany

Question 25

Example of how the body compensates with metabolic acidosis

Answer 25

deep rapid respirations

Question 26

Why is the potassium level altered in a patient with acid-base imbalance?

Answer 26

In alkalosis, potassium is shifts into the cells for hydrogen. This decreases the potassium in the ECF –> hypokalemia

Question 27

What does an arterial blood gas tell you?

Answer 27

1. Hypoxemia
2. Acid base disorder
3. pH
4. Patients ability to compensate
5. O2 status

Question 28

Respiratory acidosis

Answer 28

1. Low pH
2. High CO2
3. Build up of CO2: caused by pulmonary issues or hypoventilation
4. Accumulation/excess of CO2 in blood –> increase H+ –> decreased pH

Question 29

Respiratory alkalosis

Answer 29

1. High pH
2. Low CO2
3. CO2 deficit due to hyperventilation
4. Decreased CO2 in blood –> decrease H+ –> increased pH

Question 30

Metabolic acidosis

Answer 30

1. Acids accumulate d/t ketoacidosis, lactic acids OR bicarb is lost
2. pH is low
3. HCO3 is low
4. CO2 could be normal

Question 31

Metabolic alkalosis

Answer 31

1. Loss of acids d/t gastric loss OR increase in HCO3
2. Could be d/t an increase in intake of HCO3
3. High pH

Question 32

What are the degrees of compensation are?

Answer 32

compensated, partially compensated, or uncompensated

Question 33

How do you determine the level of compensation

Answer 33

pH, PaCO2, and HCO3 are analyzed

Question 34

How does the body compensate for a metabolic acid-base disorder?

Answer 34

Respiratory system may compensate by retaining or removing CO2.
Respiratory compensation is rapid

Question 35

How does the body compensate for a respiratory acid-base disorder?

Answer 35

Renal system may compensate by excreting or retaining hydrogen and bicarb.
Renal compensation is slow and can take up to 24 hours

Question 36

What acid-base imbalance do you expect when a patient has prolonged diarrhea?

Answer 36

Loss of HCO3
Metabolic acidosis
Dehydration

Question 37

What will the body due to compensate after the patient get metabolic acidosis from diarrhea?

Answer 37

Lungs: increase RR to blow off CO2
Kidneys: retain HCO3 and excrete H+

Question 38

How does renal disease affect acid-base imbalances?

Answer 38

kidneys have poor reabsorption of HCO3 and secrete H+

Question 39

What acid-base imbalance do you expect if your patient has prolong vomiting?

Answer 39

Loss of acids

Metabolic alkalosis

Question 40

What will the body do to compensate after the patient get metabolic alkalosis from vomiting?

Answer 40

Lungs: decrease or maintain regular RR
Kidneys: excrete HCO3 and retain H+

Question 41

What is the priority nursing intervention if your patient have metabolic acidosis

Answer 41

Perform medication reconciliation
Assess the client’s strength in the extremities.
Obtain a diet history for the past 3 days.
Initiate cardiac monitoring.

Initiate cardiac monitoring.