ABG

Question 1

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

Answer 1

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

Question 2

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

Answer 2

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

Question 3

Strong acids

Answer 3

dissociate completely in solution

Question 4

weak acids

Answer 4

dissociate partially

Question 5

Hydrogen in important in the body because…..

Answer 5

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

Question 6

Hydrogen is a component of ….

Answer 6

Sugars
Proteins
Starch
Fats

Question 7

what is a neutral pH?

Answer 7

7

Question 8

normal pH range

Answer 8

7.35- 7.45

Question 9

normal CO2 range

Answer 9

35-45

Question 10

normal HCO3 range

Answer 10

24-29

Question 11

what is the most acidic place in the body?

Answer 11

the stomach

Question 12

HCl found outside the stomach causes what?

Answer 12

damage

Question 13

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

Answer 13

LES

Question 14

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

Answer 14

false, there are different pH ranges throughout the body

Question 15

what electrolytes can acid-base affect?

Answer 15

Na+, K+, Cl-

Question 16

can pH affect hormones?

Answer 16

yes

Question 17

how does pH affect oxygen transport & delivery?

Answer 17

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.

Question 18

what pH levels are incompatible with life?

Answer 18

<6.8 or >7.8

Question 19

what are the 2 types of acids in the body?

Answer 19

Volatile acids & Non-volatile acids

Question 20

Volatile acids

Answer 20

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

Question 21

Non-volatile acids

Answer 21

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

Question 22

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

Answer 22

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

Question 23

what are buffers?

Answer 23

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

Question 24

List the 3 main buffer systems

Answer 24

Bicarbonate – Carbonic Acid Buffer
Phosphate Buffer
Protein Buffers: Hemoglobin

Question 25

Bicarbonate – Carbonic Acid

Answer 25

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-

Question 26

Phosphate Buffer 

Answer 26

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

Question 27

Protein Buffers 

Answer 27

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.

Question 28

Increase in [H+] (concentration) =

Answer 28

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 

Question 29

respiratory mechanisms

Answer 29

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.

Question 30

Kidney excretion

Answer 30

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.

Question 31

how fast do buffers function?

Answer 31

almost instantaneously

Question 32

how fast do respiratory mechanisms take to work?

Answer 32

minutes to hours

Question 33

how fast do renal mechanisms take to work?

Answer 33

hours to days

Question 34

Primary EVENT

Answer 34

The PROBLEM that initiates the acid-base imbalance 

Question 35

Primary DISORDER

Answer 35

What RESULTS from the primary event 

Question 36

Compensation mechanisms 

Answer 36

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

Question 37

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

Answer 37

Respiratory acidosis Respiratory alkalosis

Question 38

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

Answer 38

Metabolic acidosis Metabolic alkalosis

Question 39

Metabolic Alkalosis

Answer 39

too much Bicarb “OR” not enough CARBONIC ACID 

Question 40

Metabolic Alkalosis Causes

Answer 40

Taking excess baking soda, alka-seltzer = too much base RESULTS IN hypokalemia causing hydrogen to shift out the intracellular space and potassium goes into the cell Prolonged vomiting NG tube Diuretics

Question 41

Metabolic Alkalosis CM

Answer 41

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

Question 42

Metabolic Alkalosis ABG

Answer 42

pH- increased CO2 – normal HCO3- increases

Question 43

paresthesias

Answer 43

tingling of fingers and toes, perioral

Question 44

Respiratory Alkalosis

Answer 44

H²CO³ (CARBONIC ACID) DEFICIT in ECF

Question 45

Respiratory Alkalosis ABG

Answer 45

pH- increased CO2 – low HCO3- normal

Question 46

Respiratory Alkalosis Causes

Answer 46

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

Question 47

Respiratory Alkalosis CM

Answer 47

CNS over-excitability Tachypnea Light headedness Confusion, blurred vison  Paresthesia  Hyperactive reflexes seizures Coma

Question 48

Respiratory Acidosis

Answer 48

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

Question 49

Respiratory Acidosis ABG

Answer 49

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

Question 50

Respiratory Acidosis Causes

Answer 50

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

Question 51

Respiratory Acidosis CM

Answer 51

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

Question 52

Metabolic Acidosis

Answer 52

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

Question 53

Metabolic Acidosis ABG

Answer 53

pH- Low CO2- Normal HCO3- Low

Question 54

Metabolic Acidosis Causes

Answer 54

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

Question 55

Metabolic Acidosis CM

Answer 55

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

Question 56

Respiratory Acidosis/Alkalosis:COMPENSATION.

Answer 56

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

Question 57

Metabolic Acidosis/Alkalosis:COMPENSATION

Answer 57

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