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NUR 406 > ABG > Flashcards

ABG Flashcards

1
Q

Acids have _ H+ ions & can _ a H+

A

Acids have MORE H+ ions & can DONATE a H+

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2
Q

Bases (alkaline substances) have _ H+ ions, can _ a H+ ions, & _ a hydroxide ion OH-

A

Bases (alkaline substances) have LESS H+ ions, can ACCEPT a H+ ions, & GIVE a hydroxide ion OH-

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3
Q

Strong acids

A

dissociate completely in solution

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4
Q

weak acids

A

dissociate partially

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5
Q

Hydrogen in important in the body because…..

A

Helps maintain cell membranes
Helps with enzyme activity
Component of H2O and keeps the body hydrated
Helps in energy production

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6
Q

Hydrogen is a component of ….

A

Sugars
Proteins
Starch
Fats

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7
Q

what is a neutral pH?

A

7

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8
Q

normal pH range

A

7.35- 7.45

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9
Q

normal CO2 range

A

35-45

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10
Q

normal HCO3 range

A

24-29

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11
Q

what is the most acidic place in the body?

A

the stomach

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12
Q

HCl found outside the stomach causes what?

A

damage

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13
Q

what. prevents the movement of gastric acid into the esophagus?

A

LES

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14
Q

true or false: pH is the same throughout the entire body

A

false, there are different pH ranges throughout the body

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15
Q

what electrolytes can acid-base affect?

A

Na+, K+, Cl-

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16
Q

can pH affect hormones?

A

yes

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17
Q

how does pH affect oxygen transport & delivery?

A

more acidic= hgb will GIVE up oxygen more readily at the tissue.
More alkalotic= hgb will HOLD on to oxygen & not give it to tissue.

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18
Q

what pH levels are incompatible with life?

A

<6.8 or >7.8

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19
Q

what are the 2 types of acids in the body?

A

Volatile acids & Non-volatile acids

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20
Q

Volatile acids

A

converted to gas
Excreted/eliminated by the lungs
Ex: Carbonic acid (H2CO3)

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21
Q

Non-volatile acids

A

Eliminated by the kidney, Exception – Lactic acid which is Metabolized by the body – primarily the liver and kidney.
ex. Lactic acid, Phosphoric acid, Sulfuric acid, Acetoacetic acid, Beta-hydroxybutyric

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22
Q

Body produces more acids than bases d/t (1), (2), (3).

A

Ingest in food/drink
Metabolism of lipids and proteins
Cellular metabolism waste product –CO2a volatile acid

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23
Q

what are buffers?

A

Chemicals in the body that combine with acid or base to change the pH.
Accept or release a H+
Almost instantaneous.
Short-lived.

24
Q

List the 3 main buffer systems

A

Bicarbonate – Carbonic Acid Buffer
Phosphate Buffer
Protein Buffers: Hemoglobin

25
Q

Bicarbonate – Carbonic Acid

A

Main ECF buffer
CO2 (byproduct of cellular metabolism) + H2O (in serum) = carbonic acid.
Carbonic anhydrase breaks down carbonic acid
In the lungs: H2O + CO2
In the kidneys: H+ + HCO3-

26
Q

Phosphate Buffer

A

Main intracellular buffer.
H+ + HPO4-2 = H2PO4-
Hydrogen + hydrogen phosphate = dihydrogen phosphate ion

27
Q

Protein Buffers

A

Nearly all proteins can function as buffers.
Carboxyl group (COOH): weak acid that gives up H+; Ex. Amino acid, Acetic acid.
Amino group (NH2-): accept H+; Ex. Amino acids, Ammonia NH3.
Hemoglobin is considered in this group, ‘picks’ up CO2 at the cellular level.

28
Q

Increase in [H+] (concentration)=

A

pH decreases – more acidic
H+ move into the cell
More positively charged ions in the cell
K+ moves out of the cell
Electrical neutrality is restored inside the cell

29
Q

respiratory mechanisms

A

Body produces CO2
CO2 + H2O = carbonic acid (H2CO3).
Exhalation excretes carbonic acid.
Doesn’t affect fixed acids (non-volatile) like lactic acid.
Body pH can be adjusted by changing rate and depth of breathing.

30
Q

Kidney excretion

A

eliminate large amounts of acid except carbonic acid.
excrete base.
Can conserve and produce bicarb ions.
Most effective regulator of pH.
If kidneys fail, pH balance fails.
Depends on normal functioning of renal system.

31
Q

how fast do buffers function?

A

almost instantaneously

32
Q

how fast do respiratory mechanisms take to work?

A

minutes to hours

33
Q

how fast do renal mechanisms take to work?

A

hours to days

34
Q

Primary EVENT

A

The PROBLEM that initiates the acid-base imbalance

35
Q

Primary DISORDER

A

What RESULTS from the primary event

36
Q

Compensation mechanisms

A

Physiologic processes that adjust the pH back to the normal range.

37
Q

which imbalances Increase or decrease CO2 & have Changes in ventilation?

A

Respiratory acidosis
Respiratory alkalosis

38
Q

which imbalances have Changes in [H+] or bicarbonate ions?

A

Metabolic acidosis
Metabolic alkalosis

39
Q

Metabolic Alkalosis

A

toomuchBicarb “OR” notenoughCARBONIC ACID

40
Q

Metabolic Alkalosis Causes

A

Takingexcessbakingsoda,alka-seltzer=toomuchbase RESULTS IN hypokalemiacausinghydrogentoshiftouttheintracellularspaceandpotassiumgoesintothecell
Prolongedvomiting
NG tube
Diuretics

41
Q

Metabolic Alkalosis CM

A

CNS over-excitability
Confusion
Tremors
Muscle cramps
Paresthesias
Coma
N/V/D
Respdepression

42
Q

Metabolic Alkalosis ABG

A

pH- increased
CO2 – normal
HCO3- increases

43
Q

paresthesias

A

tingling of fingers and toes, perioral

44
Q

Respiratory Alkalosis

A

H²CO³ (CARBONIC ACID) DEFICIT in ECF

45
Q

Respiratory Alkalosis ABG

A

pH- increased
CO2 – low
HCO3- normal

46
Q

Respiratory Alkalosis Causes

A

Hyperventilation-primary event- CO2 blown off.
Increased metabolic demands- Fever, sepsis.
Medications
Acute anxiety
Hypoxia
PE or lung disease
CNS lesions
Ventilator settings

47
Q

Respiratory Alkalosis CM

A

CNSover-excitability
Tachypnea
Lightheadedness
Confusion,blurredvison
Paresthesia
Hyperactive reflexes
seizures
Coma

48
Q

Respiratory Acidosis

A

H²CO³ excess in ECF (too much acid/H+)

49
Q

Respiratory Acidosis ABG

A

pH- low
CO2 – high
HCO3- normal
HCO3- WNL with acute respiratory acidosis; no time for kidneys to compensate.

50
Q

Respiratory Acidosis Causes

A

Hypoventilation“primary event”- CO2 retained (H+).
cardiopulmonary arrest
head injury
narcotics/sedatives anesthesia
pulmonary disorders (acute asthma,COPD exacerbation, pneumonia, resp failure)
pain
abdominal distension
airway obstruction
chest wall deformities
neuromuscular problems

51
Q

Respiratory Acidosis CM

A

CNS depression causing hypoventilation, dyspnea, respiratory distress, shallow respirations, H/A, restlessness, confusion
tachycardia, arrhythmias, LOC, stupor, coma

52
Q

Metabolic Acidosis

A

HCO³ (BICARBONATE) DEFICIT in ECF.
excess acids are added OR bicarb is lost.

53
Q

Metabolic Acidosis ABG

A

pH- Low
CO2- Normal
HCO3- Low

54
Q

Metabolic Acidosis Causes

A

Renal failure
Fistulas
Diabetes (Type 1 DM-DKA)
Lactic Acidosis
Prolonged diarrhea(relative increased acid d/t loss of HCO3)
Starvation(body using fat for energy resulting in ketosis)
Medication overdose: ASA
Shock and cardiac arrest

55
Q

Metabolic Acidosis CM

A

CNS: Lethargy, drowsiness, Confusion, Tremors, muscle cramps, Paresthesias.
Hypotension
Hyperkalemia
Deep breathing: Kussmaul respirations (DKA)
Fruity Odor Breath (DKA)

56
Q

Respiratory Acidosis/Alkalosis:COMPENSATION.

A

the KIDNEY compensates by either: conserving (reabsorbing) HCO3 ions (acidosis correction) or excreting HCO3 ions (alkalosis correction)

57
Q

Metabolic Acidosis/Alkalosis:COMPENSATION

A

the LUNGS compensates by either: conserving CO2 ions (hypoventilation/alkalosis correction) or excreting CO2 ions (hyperventilation/acidosis correction)

NUR 406 (7 decks)

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