Acid-Base Flashcards

1
Q

What causes an increase in acid production?

A
  • Excessive oxidation of fatty acids
  • Hypermetabolism
  • Excessive ingestion of ethanol and salicylate
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2
Q

What causes excessive oxidation of fatty acids?

A
  • Starvation
  • Ketoacidosis
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3
Q

What causes hyper metabolism?

A
  • Exercise
  • Seizures
  • Fever
  • Ischemia
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4
Q

What causes an increase in acid loss?

A
  • Vomiting
  • Gastric suctioning
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5
Q

What causes a decrease in acid excretion?

A
  • Renal failure
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6
Q

What causes bicarbonate loss or underproduction?

A
  • Diarrhea
  • Excessive ileostomy drainage
  • Pancreatitis
  • Liver failure
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7
Q

What causes an increase in bicarbonate?

A
  • Alkaline ingestion
  • Excessive sodium bicarbonate administration
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8
Q

What causes increased/decreased levels of CO2?

A
  • Respiratory conditions
  • Opiate overdose
  • Anxiety
  • Fever
  • COPD
  • Inadequate chest expansion
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9
Q

Normal pH levels

A

7.35 - 7.45

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10
Q

Normal PaCO2

A

35 - 45 mmHg

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11
Q

Acidotic PaCO2

A

<35 mmHg

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12
Q

Alkalotic PaCO2

A

> 45 mmHg

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13
Q

Normal HCO3

A

22 - 28 mEq/L

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14
Q

Acidotic HCO3

A

<22 mEq/L

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15
Q

Alkalotic HCO3

A

> 28 mEq/L

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16
Q

Normal PaO2

A

80 -100 mmHg

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17
Q

Normal SaO2

A

> 95%

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18
Q

Respiratory acidosis

A
  • Increased CO2
  • Decreased pH
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19
Q

Causes of respiratory acidosis

A
  • Hypoventilation
  • Decreased respiratory drive/respiratory depression
  • Neuromuscular disorders
  • Airway obstruction/alveolar capillary exchange
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20
Q

Respiratory alkalosis

A
  • Increased pH
  • Decreased PaCO2
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21
Q

Metabolic alkalosis

A
  • Increased pH
  • Increased HCO3
22
Q
  • Causes of metabolic alkalosis
A
  • Loss of gastric acid
  • Loss of K+
  • Cushing’s syndrome
  • Ingestion of excess antacids, baking soda
  • IV administration of bases
23
Q

Examples of loss of gastric acid

A
  • Severe vomiting
  • Nasogastric suctioning
  • Gastric fistulas
24
Q

Examples of K+ loss

A
  • Excessive diuretic therapy
25
Q

Examples of IV administration of bases

A
  • Sodium bicarbonate
  • TPN
  • Lactate in Ringer’s lactate
  • Citrate in massive amounts of blood transfusions
26
Q

Metabolic alkalosis vitals

A
  • Tachycardia
  • Normal - hypotensive BP
27
Q

Metabolic alkalosis respiratory s/s

A
  • Hypoventilation
28
Q

Metabolic alkalosis near s/s

A
  • Irritable
  • Lethargic
  • Confused
  • Headache
29
Q

Metabolic alkalosis neuromuscular s/s

A
  • Tetany
  • Tremors
  • Numbness/tingling in fingers/toes
  • Muscle cramps
  • Hyperactive reflexes
  • Seizures
30
Q

Metabolic alkalosis cardiac s/s

A
  • dysrhythmias r/t hypokalemia
31
Q

Electrolyte problems associated with metabolic alkalosis

A
  • Hypokalemia
  • Hypochloremia
  • Hypocalcemia
32
Q

Metabolic acidosis causes

A
  • DKA
  • Starvation
  • Alcoholism
  • Rhabdomyolysis
  • Ingestion of aspirin/salicylates
  • Chronic renal failure
  • Severe lung problems
  • Prolonged diarrhea
  • Pancreatitis
33
Q

Metabolic acidosis vitals

A
  • Bradycardia
  • Hypotension
  • Tachypnea
34
Q

Metabolic acidosis cardiac s/s

A
  • Dysrhythmias
  • Possible cardiac arrest
35
Q

Metabolic acidosis respiratory s/s

A
  • Kussmaul respirations
  • Deep, rapid respirations
36
Q

Metabolic acidosis neuro s/s

A
  • Lethargic
  • Confused
  • Dizziness
  • Headache
  • Decreased LOC, stupor, coma
37
Q

Metabolic acidosis GI s/s

A
  • N/V/D
  • Abdominal pain
38
Q

Metabolic acidosis neuromuscular s/s

A
  • Muscle Weakness
39
Q

Metabolic acidosis skin s/s

A
  • Cold
  • Clammy
40
Q

Normal anion gap

A

8 - 12 mol/L

41
Q

DKA labs

A
  • Hyperglycemia >250
  • AGAP open >12
  • Metabolic acidosis
  • Serum HCO3 <18
  • Electrolyte imbalances
42
Q

DKA triggers

A
  • Infections
  • Pregnancy
  • Insufficient/missed insulin
  • Trauma/emotional stress/surgery
  • MI
  • Exercise
  • Alcohol abuse
  • Medications
43
Q

What infections are common triggers for DKA?

A
  • PNA
  • UTI
  • Sepsis
  • Pancreatitis
44
Q

What medications are common triggers for DKA?

A
  • Corticosteroids
  • Thiazide diuretics
  • Atypical antipsychotics
45
Q

DKA s/s

A
  • Polydipsia
  • Polyuria
  • Polyphagia
  • N/V
  • Blurred vision
  • Weakness/lethargy
  • Fruity/rotting fruit breath
  • Kussmaul respirations
46
Q

DKA vital signs

A
  • Tachycardia
  • Hypotension
  • Tachypnea
47
Q

DKA neuro s/s

A
  • Change in mental status
  • Malaise
  • Lethargy
48
Q

DKA integumentary s/s

A
  • Warm
  • Dry
  • Flushed
49
Q

DKA GI s/s

A
  • N/V
  • Weight loss
  • Increased thirst
  • Fruity breath
50
Q

DKA GU s/s

A
  • Increased urination
  • Significant dehydration
51
Q

DKA

A