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Foundations 3 > ACID BASE > Flashcards

ACID BASE Flashcards

1
Q

Function of Acid-Base

A

Homeostasis
Body fluids
Kidneys
Lungs

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2
Q

How do we measure acid-base?

A

PH

- Normal is 7.35-7.45

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3
Q

Acid- Base Buffer

A

Carbon Dioxide mixes with water to form carbonic acid

Bicarbonate and hydrogen ions mix to form carbonic acid

Both processes require carbonic anhydrase to occur

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4
Q

CO2 is controlled by what

A

Respiratory

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5
Q

HCO3- is controlled by what

A

Metabolic

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6
Q

Breathing controls what acid

A

CO2

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7
Q

RR less than 12 promotes?

A

increased CO2

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8
Q

RR greater than 20 promotes?

A

decreased CO2

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9
Q

How fast does the respiratory system respond to change?

A

Immediately but effect is weak

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10
Q

The kidneys primarily control acid-base balance through the retention or excretion of two substances

A

Hydrogen ions

Bicarbonate ions

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11
Q

Renal System responds how?

A
  • it takes hours to days

- very effective though

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12
Q

How do we figure out what acid-base status is in real world?

A

Arterial Blood Gas (ABG)

Sample of blood taken from an artery
Most common radial or femoral

Run through a machine for various values

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13
Q

Low pH
High Co2
Low Hco3

A

Acidic Resp is opposite and metabolic is equal

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14
Q

High pH
low Co2
High HCO3

A

Alkaline

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15
Q

Compensation

A

If ph is below 7.35 body will compensate to 7.31-7.35
If pH is higher than 7.45 body will compensate to 7.41-7.45
- 7.4 is midpoint

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16
Q

Uncompensated

A

When one resp or metabolic is abnomal and pH is abnormal

17
Q

Partially Compensated

A

When all 3 are abnormal

18
Q

Compensated

A

when both bicarb and resp are abnormal but pH is normal

19
Q

Metabolic Acidosis Causes

A

Excess carbonic acid production or bicarbonate deficit with multiple causes:
- DKA and Lactic Acid accumulation from not enough oxygen in tissues
-Severe Diarrhea: Dehydration, can lead to shock or lactic acid buildup
Stool contains bicarb and severe diarhhea means prolonged loss of bicarbonate
- Renal disease: decrease production of bicarb

20
Q

M. Acidosis Compensation

A

If there isn’t a problem with renal function, then the kidneys will attempt to produce more bicarbonate

However, usually the bicarbonate deficit exceeds the amount the kidneys can produce, so it is not enough.

  • Respiratory compensates with hyperventilation but is weak
21
Q

S/s of M. Acidosis

A

Kussmaul’s respirations?

Lethargy, fatigue, coma

Hypertension, dysrhythmias
- Hyperkalemia since potassium exchanges with hydorgen ions

22
Q

M. Acidosis Tx

A

Treat the underlying cause

  • If the kidneys are impaired, then hemodialysis is a priority
  • If the patient is in a state of DKA, then insulin administration is a priority
  • If the patient is in a type of shock state, then fluid replacement or other shock treatment is a priority
23
Q

What can be done for hyperkalemia with M. Acidosis?

A

Insulin and D5, loop diuretics like fuerosimde, sodium polyestrene, and calcium gluconate

24
Q

Metabolic Alkalosis Causes?

A
  • Loss of hydrochloric acid from vomiting
  • Gastric suctioning
  • Bicarb gain esp in pts with renal insuffiency
25
Q

M. Alkalosis Comp

A

Renal excretion of bicarbonate

Respiratory, decrease in respiratory rate
- Resp effect first

26
Q

M. Alkalosis S/S

A
  • hyperactive reflexes
  • Parenthesia
  • tetany
  • seizures
  • Resp depression
27
Q

Tx for M. Alkalosis

A

-Adequate hydration
Good for prolonged vomiting or gastric suction
-0.9% sodium chloride
-Arginine hydrochloride
Raises chloride levels which are reduced from gastric suction or gastric loss
-A diuretic: Diamox (acetazolamide)
Carbonic anhydrase inhibitor, why would this help?
Carbonic anhydrase is the compnenet in the buffer system that causes bicarbonate to turn into carbonic acid
If it is inhibited, then bicarbonate is prevented from turning into carbonic acid and instead gets excreted.

28
Q

Resp Acidosis CAuse

A

-Hypoventilation: Respirations < 12 per minute?
-Respiratory Failure
Injury to the Medulla
What is this?
CNS resp control center

Overdose of what types of medications?
Opiods, benzos, anything with sedative effects

29
Q

Resp Acidosis Comp

A

Unlike metabolic processes where the kidneys can still try to compensate

Respiratory acid-base imbalances are due to impaired respiratory function

Compensation is only through renal compensation

Kidneys will retain bicarbonate ions or excrete hydrogen ions
Slow process to start

30
Q

Resp Acidosis S/S

A 
Mental status changes may occur first clinically
Irritability
Disorientation
Lethargy
Coma
Headache

Tachycardia

31
Q

TX for obstructive breathing condition with Resp Acidosis

A

Priority is to treat the underlying cause or what process is causing the reduced respiratory rate

For an obstructive type of breathing condition
Bi-level positive airway pressure (BiPAP)
Mechanical ventilation in more severe cases

32
Q

TX for sedative med or overdoes that causes resp acidosis

A

Antidote for offending agent, what is an example?

Naloxone (Narcan) for opiod overdose

33
Q

Other interventions to improve breathing depth and quality

A

Oxygen administration
Keeping the head of bed elevated
Antibiotics if pneumonia is involved

34
Q

Resp Akalosis Cause

A

Acid deficit caused by hyperventilation or pulmonary disorders

35
Q

What are some conditions that cause hyperventilation’s

A 
Anxiety
Fever
Pain
Trauma
Anemia
Asthma
Pulmonary embolism
Cerebrovascular accident or stroke
36
Q

Resp Alkalosis Comp

A

Bicarbonate shifts into cells in exchange for Chloride ions

If alkalosis persists renal excretion of bicarbonate can happen

37
Q

Resp Akalosis S/s

A

Neuromuscular symptoms
Paresthesia, dizziness, vertigo, tetany

Cardiovascular symptoms
Tachycardia, dysrhythmias, excessive diaphoresis

38
Q

Resp Alkalosis Tx

A

Priority is fixing underlying cause
-If in pain or anxiety, an intervention that targets pain or anxiety

  • If due to asthma, a bronchodilator
  • If due to anemia, restoration of hemoglobin

Foundations 3 (5 decks)

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