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Nurs 186 > Acid Base > Flashcards

Acid Base Flashcards

1
Q

Base

A

Accept H ions

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2
Q

Carbohydrate metabolism

A

(CO2) carried in plasma as carbonic acid

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3
Q

CO2 in plasma..

A

Becomes bound with water making it carbonic acid.

-binding of water is how it gets its H ion

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4
Q

Metabolism of fats

A

Ketoacids

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5
Q

Metabolism of proteins

A

Sulfuric acid

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6
Q

Tissue hypoxia

A

Lactic acid

-anabolic process

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7
Q

Cell destruction

A

Ex.chemotherapy

- acids get released from inside of cells into the plasma

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8
Q

Fixed acids

A

Ketoacids
Sulfuric acids
Lactic acids
Cell destruction

-excreted through the kidneys

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9
Q

Bicarbonate

A
  • weak base
  • most abundant base in body
  • get lots of bicarbonate through amino acids
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10
Q

Ammonia

A
  • strong base

- largely made in kidneys

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11
Q

Normal pH

A

7.35-7.45

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12
Q

Fatal pH range

A

Below 6.9 or above 7.8

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13
Q

Carbonic acid to bicarbonate ratio

A

1 part carbonic acid per 20 parts bicarbonate

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14
Q

Four reasons of acidosis

A
  • over production of H ion
  • insufficient elimination of H ion
  • under production of alkali
  • over excretion of alkali
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15
Q

Key S/S of acidosis

A

-depressed CNS
-skeletal muscle weakness
-kussmaul respiration during metabolic acidosis
J

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16
Q

4 reasons of alkalosis

A
  • over production of base
  • insufficient elimination of base
  • underproduction of acid
  • excessive elimination of acid
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17
Q

Key S/S of alkalosis

A
  • anxiety,irritability
  • increased CNS activity
  • increased HR
  • low BP
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18
Q

Buffer systems

A

1 rapid acting system

  • take care of most mild imbalances
  • reduce or increase H ions in plasma
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19
Q

Bicarbonate buffer system

A

Carbonic acid system

20
Q

Phosphate buffer system

A

Most active in renal tubules

21
Q

Protein buffer system

A

Hemoglobin has ability to absorb H ions

Most common buffers

22
Q

Respiratory system

A
  • controlled by the medulla
  • works by only controlling CO2
  • second line of defense after buffer I g systems
  • can only correct imbalances for a number of hours
23
Q

Kidney regulation

A
  • most powerful regulator
  • can take days to regulate
  • increase excretion or reabsorption of acids and bases
24
Q

Respiratory acidosis

A
  • results in retention of CO2

- the kidney will excrete more H ions and hold bicarbonate

25
Q

Clinical manifestations of respiratory acidosis

A
  • COPD
  • pneumonia
  • asthma
  • bronchitis
  • certain meds
  • broken ribs
  • obesity
26
Q

S/S of acute respiratory acidosis

A
  • altered LOC
  • flushed warm skin(CO2) is a vasodilator
  • headache
  • reduced muscle tone
  • ineffective respirations(source of problem
27
Q

Potassium shuffle with acidosis(how body fixes it)

A

Potassium moves from inside of the cell to allow H+ ion to enter the cell

Result in plasma will be more potassium, less acidity, and higher pH

28
Q

Treatment for respiratory alkalosis

A
  • drug therapy: bronchodilators,anti inflammatories, mucolytics
  • oxygen
  • positioning
  • suction
  • mechanical effort

-asses breathing effort and lung sounds

29
Q

Respiratory alkalosis

A

-caused by hyperventilation, leads to a decrease in CO2

30
Q

Clinical situation of respiratory alkalosis

A
  • fever
  • pain
  • CVA
  • high altitude
31
Q

What will kidneys do to help respiratory alkalosis

A

Respond by increase excretion of bicarbonate and increase retention of H+ ions

32
Q

Potassium shuffle with alkalosis

A

Plasma potassium moves from the plasma into the cell to allow H+ ion to enter the plasma

  • result in plasma will be less potassium, more acidity, and lower pH
33
Q

S/S of respiratory alkalosis

A
  • tachypnea
  • dizziness
  • muscle weakness
  • syncope

-parenthesias, seizures, and hypereflexia due to hypocalcemia caused by increased pH

34
Q

Treatment of respiratory alkalosis

A
  • relieve anxiety
  • breath more slowly
  • partial rebreather mask
  • seizure precautions
  • reduce fever
35
Q

Metabolic acidosis

A

-too many fixed acids lead to lower pH

  • diabetes poster child
  • anorexia, bulimia, poor diet: not taking in adequate energy sources and body breaks down fats and proteins releasing acids
  • renal failure
36
Q

Metabolic acidosis by lose of bases leadin to over abundance of acids

A
  • diarrhea
  • malabsorption disorders
  • pancreatic disorders
37
Q

How will the lungs try to help metabolic acidosis

A

Kussmaul’s respirations: deep rapid respirations

38
Q

What can kidneys due to aid in metabolic acidosis

A

Excrete H+ buffered with ammonia in the urine, retain bicarbonate

39
Q

S/S of metabolic acidosis

A
  • decreased CNS
  • muscle weakness
  • hyperkalemia(more K in plasma)
  • Kussmaul’s respirations
40
Q

Normal anion gap

A

8-14

-larger than 14 is an accumulation of acids

41
Q

Treatment of metabolic acidosis

A
  • for diabetes give insulin(stops production of keytone acids)
  • GI loss: antidarrheals
  • give bicarbonate as ordered
  • renal failure: dialysis
42
Q

Metabolic alkalosis

A

Excessive intake or loss of acids: leads to an over abundance of base

Hydrochloric acid loss: NG tube/ vomiting
-loss of chloride leads to increase in bicarbonate retention in kidneys( making the situation worse)

43
Q

Metabolic alkalosis and diuretics

A

Hypocalcemia often occurs due to diuretics

-this loss of potassium leads to increased H+ excretion from kidneys and results in alkalosis

44
Q

S/S of alkalosis

A

Confusion
Anxiety
Irritability

-paresthesias, seizure, hyperreflexia due to hypocalcemia caused by increased pH

45
Q

Treatment of metabolic alkalosis

A
  • decrease/ chance diuretics
  • acetazalomide Diamox(diuretic) to increase renal excretion of bicarbonate
  • decrease suctioning
  • control vomiting
  • provide chloride, potassium in IV
46
Q

Acids

A

Give away H ions

Nurs 186 (12 decks)

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