acid/base Flashcards
lung chemicals
CO2 - acid
kidney chemicals
H - acid
HCO3 - base
how long does it take kidneys to compensate?
hours to days, but efficiently
how long does it take lungs to compensate?
occurs quickly, but less efficiently than kidneys
respiratory acidosis
problem organ
lung
respiratory acidosis
problem chemical
too much CO2 (acid)
respiratory acidosis
hypoventilating or hyperventilating?
hypoventilating
respiratory acidosis
compensatory organ
kidneys
respiratory acidosis
how will compensating organ work?
kidneys
excrete H
retain HCO3
respiratory acidosis
pH high or low?
low
respiratory acidosis
cause + how
CO2 retention
- mid-abdominal incision
- narcotics (decreased…
- sleeping pills …RR)
- pneumothorax (lungs can’t…
- collapsed lung …expand/contract properly)
- pneumonia (improper gas exchange(
respiratory acidosis
s/s
headache, confused, sleepy
if not corrected, coma
s/s hypoxia
early s/s of hypoxia
restlessness & tachycardia
respiratory acidosis
tx
fix the breathing problem!
- treat pneumonia, postural drainage, percussion, deep breathing, suctioning, fluids, elevate HOB, IS, chest tubes
respiratory alkalosis
problem organ
lungs
respiratory alkalosis
compensatory organ
kidneys
respiratory alkalosis
problem chemical
not enough CO2 (acid)
respiratory alkalosis
how will compensatory organ work?
kidneys;
retain H
excrete HCO3
respiratory alkalosis
gaining or losing CO2?
losing
respiratory alkalosis
hyperventilating or hypoventilating?
hyperventilating
respiratory alkalosis
cause + how
insufficient CO2 (hyperventilating)
- hysterical
- acute aspirin overdose
acute aspirin overdose (results in what acid/base issue and why?)
respiratory alkalosis
- triggers respiratory center in brain resulting in hyperventilation
respiratory alkalosis
s/s
cerebral vasoconstriction
- lightheaded
- faint
- peri-oral numbness
numbness/tingling in fingers and toes
respiratory alkalosis
tx
DO NOT WAIT UNTIL KIDNEYS KICK IN
- breathe into paper bag
- sedate client to decrease RR
- treat cause
- monitor ABG
respiratory acidosis OR alkalosis, the problem is…
CO2 (acid)
restlessness = think
hypoxia first!`
metabolic acidosis
problem organ
kidneys
metabolic acidosis
compensatory organ
lungs
metabolic acidosis
how compensatory organ works
respiratory rate will increase to blow off CO2 (acid)
metabolic acidosis
problem chemicals
retaining H+
does not have enough bicarb
metabolic acidosis
pH low or high?
low
metabolic acidosis
causes + how x4
DKA
starvation
- cells starving for glucose = breakdown of protein, fat = ketones = acids
renal failure severe diarrhea (base in lower GI tract lost)
metabolic acidosis
s/s
depends on the cause
- hyperkalemia
- increased respiratory rate
metabolic acidosis
s/s hyperkalemia
muscle twitching, muscle weakness, flaccid paralysis, arrhythmias
metabolic acidosis
tx
treat the cause (insulin, eat, anti-diarrhea)
metabolic acidosis
helpful drug + action
IV push Na bicarb - won’t fix problem, buys time to correct real problem
metabolic alkalosis
problem organ
kidneys
metabolic alkalosis
compensatory organ
lungs
metabolic alkalosis
compensatory organ works how
decrease RR to retain CO2
metabolic alkalosis
problem chemicals
retaining HCO3
excreting H
metabolic alkalosis
pH high or low?
high
metabolic alkalosis
causes
loss of upper GI contents (ng tube, vomit)
too many antacids
too much IV bicarb
metabolic alkalosis
s/s
depends on cause!
- alterations in LOC
- decreased serum K
- monitor for muscle cramps and life threatening arrhythmia
metabolic alkalosis
tx
fix the problem
replace K+
metabolic alkalosis + K
hypokalemia
metabolic acidosis + K
hyperkalemia
ABG: compensated
pH normal
pCO2 wack
pHCO3 wack
ABG: uncompensated
pH wack
pCO2 normal
pHCO3 normal
ABG: partially compensated
pH wack
pCO2 wack
pHCO3 wack
