Acid and Bases

Question 1

(T/F) Hydrogen ions (H+) are acidic

Answer 1

True

Question 2

(T/F) HCO3- is a base

Answer 2

True

Question 3

(T/F) CO2 is acidic

Answer 3

True

Question 4

CO2 and water combine to create ____ in the body?

An acid or base

Answer 4

Acids; Carbonic Acid (H2CO3)

Question 5

(T/F) As respiration rate goes up, pH is more basic

Answer 5

True (ex: hyperventilation; you’re breathing to quickly and getting rid of too much acid)

Question 6

(T/F) As respiration rate goes down, pH becomes more acidic

Answer 6

True (ex: Hypoventilation, your breathing is too slow and isn’t getting rid of enough acid)

Question 7

(T/F) The respitatory system is effective within minutes to hours to fix acid-base imbalances

Answer 7

True

Question 8

(T/F) The renal systems excretes HCO3- (base) and reabsorbs H+ (acid)

Answer 8

False, the renal system excretes acids (H+) and reabsorbs bases (HC03-)

Question 9

(T/F) The renal system is the slowest reaction to acid-base imbalances, taking hours to day for a full response

Answer 9

True

Question 10

(T/F) As acid excretion goes up, pH becomes more basic

Answer 10

True

Question 11

As acid excretion goes down, pH becomes more acidic

Answer 11

True, acid excretion going down means you’re holding on to more acid

Question 12

What is the different between respiratory imbalances and metabloic imbalances?

Answer 12

Respiratory is changes in H2CO3 concentration (carbonic acid) while metabolic imbalances is a change in HCO3- concentration (bicarbonate concentration)

When you see changes in H2CO3 but none on HCO3, it’s respiratory. When you see it on HCO3 but not on H2CO3, ot’s metabolic.

Question 13

What is an example of respiratory acidosis? What acid is building up?

Answer 13

Hypoventilation (Ex: COPD, Pneumonia, sleep apnea, sedative overuse)
Carbonic acid (H2CO3)

Kidneys work to reverse this

Question 14

What are clinical manifesations of respiratory acidosis?

There are six

Answer 14

Lethargy, confusion, coma
Dizziness
Headache
Low BP
Seizures
Hypoventilation

Question 15

Whar is an example of respiratory alkalosis?

Answer 15

Hyperventilation (ex: pneumonia, pulmonary embolus, high altitude)

Question 16

What are clinical manifestations of respiratory alkalosis?

Answer 16

Confusion
Dizziness
Headache
Tachycardia
Nausea, vomiting, diarrhea
Tetany
Numbness, tingling
Seizures
Hyperventilation

Question 17

(T/F) During metabolic acidosis, there is a loss of bicarbonate

Answer 17

True, HCO3- (base) is loss which causes a rise in acid (ex: diarrhea, kidney disease)

The lungs compensate for this by increasing CO2 excretion (hyperventilation)

Question 18

What are clincial manifesations of metabolic acidosis?

One important one

Answer 18

Lethargy, confusion, coma
Dizziness
Headache
Low BP
Nausea, vomiting, diarrhea
Muscle weakness
Kussmaul respirations (if compensation is happening)

Question 19

(T/F) Metabolic alkalosis is a loss of acid

Answer 19

True (ex: vomiting, gastric suction)

There’s a gain in bicarbonate HCO3- (craving of baking soda) which leads to a buildup of base

Question 20

What are clincial manifestations of metabolic alkalosis?

Answer 20

Lethargy, confusion
Irritability
Headaches
Tremors
Tingling
Seizures
Hypoventilation (if compensation is happening)

Question 21

What is the range for pH?

Answer 21

7.35-7.45

Question 22

What is the range for PaCO2?

Answer 22

35-45 mm Hg

Question 23

What is the range for Bicarbonate (HCO3-)?

Answer 23

22-26 mEq/L

Question 24

What is the range for PaO2?

Answer 24

80-100 mm Hg

Question 25

What is the range for SaO2?

Answer 25

Greater than (>) 95%

Question 26

Georgia is a 54 year old trans woman with a history of Chronic Obstructive Pulmonary Disorder (COPD). She has not been using her inhaler and has been struggling to breathe.
She states “I feel so dizzy and now I have a headache!”. Her respiratory rate is 14 breaths per minutes and her BP is 89/59.
Georgia is most likely experiencing:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis

Answer 26

C. Respiratory acidosis

Question 27

Joaquin is a 27 year old male patient who was skiing in the mountains of Colorado and became increasingly short of breath. His respiratory rate is 30 respirations per minute. His heart rate is 123 BPM and he reports numbness and tingling in his fingers and toes.
Joaquin is most likely experiencing:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis

Answer 27

A. Respiratory alkalosis

Question 28

Gary is a 73 year old man with a history of Chronic Kidney Disease. He has not been taking his medication for the past week as he has felt sick. He has also been having several days of diarrhea. Now, he reports dizziness, headache, and overall weakness. The nurse notes Kussmaul respirations.
Gary is most likely experiencing:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis

Answer 28

D. Metabolic acidosis

Question 29

Keisha is a 34 year old pregnant woman who presents with hyperemesis of pregnancy. She has not been able to keep down any meals and vomits each time she tries to eat. The only thing that she tolerates is her strange craving for baking soda. The nurse knows that this is PICA, an eating disorder, common in pregnancy and deficiencies where patient’s crave non-food items.
Now, Keisha is reporting headache and irritability. You notice tremors in both her hands.
Keisha is most likely experiencing:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis

Answer 29

B. Metabolic alkalosis