acid and base imbalences Flashcards
1
Q
what is the perfect range for pH
A
- 4
- range from 7. 35 - 7.45
2
Q
what is acidosis
A
- low pH is anything lower than 7.35 (death results with a pH of 6.8)
- process that adds acid or eliminates base from the body
3
Q
what’s alkalosis?
A
- high pH is anything higher than 7.45 (death results in 7.8 pH)
- process that adds a base or eliminates acid from body fluids
4
Q
what is a buffer?
A
- substance that reacts with an acid or base to prevent a large change in pH
5
Q
what is alkalemia?
A
- signifying an arterial blood pH of more than 7. 45
6
Q
what is acidemia?
A
- signifying arterial blood pH of less than 7.35
7
Q
what is a volatile body acid?
A
- carbonic acid or H2co3 that helps w/ homeostasis
- weak acid that does not release hydrogen easily
- w/ carbonic anhydrase hormones become H20 and Co2, gets rid of volatile acid
- can be eliminated as co2 through ventilation
8
Q
what is a non - volatile acids?
A
- strong acids - release hydrogen
- secreted into & eliminated w/ urine
- ex: lactic acid
9
Q
what are examples of non - volatile acid?
A
- sulfuric stomach acid
- phosphoric & organic acids
10
Q
what are the 3 chemical buffer systems?
A
- chemical buffers
- respirator buffers
- renal system
11
Q
what is the chemical buffer system
A
- can be carbonic acid and bicarbonate
- on the sense in seconds
- already present in the tissue and will handle minor changes in acid / base balance
12
Q
what is the renal system regulated by?
A
- bicarbonate
13
Q
what are the characteristics of the renal system as a buffer?
A
- is the third resort
- is slower but lasts longer
14
Q
A
- distal tubule of kidney secrets H into the urine and reabsorbs bicarbonate (HCO3)
15
Q
what are the other buffers in the chemical buffer system?
A
- protein (hemoglobin)
- ion exchange, between ICF and ECF (of K)
16
Q
what is the carbonic acid part of the buffer system?
A
- major plasma buffer system
- lungs blow out co2 to decrease carbonic acid
- kidneys reabsorbed or create new bicarb
17
Q
what is the main function of the raspatory buffer system?
A
- to blow out co2 to decrease carbonic acid
18
Q
how long does the raspatory buffer system take to respond?
A
- takes mins to hours after chemical buffers
19
Q
does hyperventilation bring more co2 in or push it out?
A
- push it out so theres less in the blood
19
Q
when does the renal buffer system respond?
A
- responds within hours to days
- slowest of the 3
- pees out h+ and reabsorbs bicarb
20
Q
what is in defect with respiratory alkalosis?
A
- low carbonic acid (co2)
21
Q
what is in excess with respiratory acidosis?
A
- carbonic acid is in excess
22
Q
what is metabolic alkalosis in excess of?
A
- bicarb is in excess
23
Q
what is metabolic acidosis in defect of?
A
- bicarb is low
24
what causes respiratory acidosis?
- HYPOVENTILATION
- drug OD bc you aren't breathing
- pulmonary edema bc less breathing
- chest trauma
- COPD
- airway obstructio
25
what causes metabolic acidosis?
- DKA = too much glucose bc insulin not working, cells feel like they're starving and break down fat for energy, and fats have acids and acid is ketones that make the body acidic
- renal failure
- severe diarrhea = bc gets rid of all the base
- sepsis and shock = low bp, less blood to cells, ischemia & hypoxia, anaerobic metabolism, lactic acid
26
what causes raspatory alkalosis?
- HYPERVENTILATION
- fever
- pregnancy
- ANXIETY = bc hyperventilation
- pulmonary emboli = bc hypervent
27
what causes metabolic alkalosis?
- vomiting bc you are voming out all of the acid
- over use of antiacids = too much base
- potassium wasting diuretics = leads to hypokalemia
28
what does ROME stand for
R = respiratory
O = opposite
M = metabolic
E = equal
29
if someone has respiratory acidosis what will their pH and pCO2 be
- low pH, high pCO2
30
what can respiratory acidosis cause in the body?
- due to HYPOventilation = not getting co2 out
- rapid, but shallow breaths
- low BP and vasodilation
- dyspnea = can't catch breath
- hyperkalemia = too much K+
- dysthymia = irregular hr bc too much K+
- Drowsiness, dizziness, disorientation
- Muscle weakness, hyperreflexia (overactive body reflexes)
31
how should the nurse assess someone w/ respiratory acidosis?
- watch resp status
- provide pulmonary hygiene
- monitor ABG and ECG
- high flowers position
- pursed lip breathing
32
what is the treatment for resp acidosis?
- bronchodilators
- help mucus
- antibodies for infection
33
what can happen to the body due to resp alkalosis?
- HYPERVENTILATION
- tachycardia = fast hr
- hypokalemia
- low bp
- numbness and tingling of extremities bc no o2 getting to extremities
- confusion
- lightheaded
- vomiting
34
what strategies should be used for someone with resp acidosis?
- assess & monitor resp status
- provide calm environment
- have pt breath in paper bag
35
whats the treatment for resp alkalosis?
- sedatives
- anti anxiety meds
36
what happens to the body with metabolic acidosis?
- headache
- low bp
- HYPERkalemia
- muscle twitching
- warm flushed skin bc vasodilation
- nausea, vomiting
- confusion
- Kussmaul respirations =compensatory hyperventilation = heavy breaths to try and breathe in more co2, breathing more out than in
37
how do nurses assess metabolic acidosis?
- monitor VS and resp status (compensatory mechanism)
- assess LOC
- monitor ABG, ECG, K+
38
how do we treat metabolic acidosis?
- treat cause
- reverse DKA or diarrhea
39
when body is in metabolic alkalosis what are the clinical manifestations?
- compensatory hyperventilation
- restlessness then lethargy
- dysrhythmias (tachycardia)
- Nausea, vomiting
- hypokalemia
40
how to assess a PT with metabolic alkalosis?
- Assess & monitor respiratory status
- Monitor LOC (level of consciousness)
- Monitor ABG, ECG, and electrolytes (K+)
- Teach proper use of antacids (!!)
41
How to treat a PT with metabolic acidosis?
- treat the underlying problem
- CI administration to enhance renal absorption
42
how to tell when ABG's are uncompensated?
- pH abnormal
- and one of the other to will be abnormal, one will be normal
43
how to tell when the ABG's are part compensated?
- everything is abnormal
44
how to tell when ABG's are fully compensated?
- pH normal
- other valvules abnormal
