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Med/Surg 1 Exam 1 > Acid/Base > Flashcards

Acid/Base Flashcards

1
Q

Nonvolatile Acids (4)

A

Lactic acid: cellular death - anaerobic activity
Hydrochloric acid: stomach
Phosphoric acid: phospho-lipid
Sulfuric acid: sulfuric breakdown

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2
Q

Volatile Acid (1)

A

Carbonic acid

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3
Q

Buffers are substances that prevent what?

How?

A

Prevent major changes in pH

By releasing H+ ions

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4
Q

Which system gets rid of “waste” quicker?

Slower?

A

Respiratory (Minutes to hours)

Renal (Hours to days)

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5
Q

Pro and con of buffers?

A

React quickly

But have limited capacity to maintain pH

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6
Q

Main buffer is?

A

Bicarbonate-carbonic buffer

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7
Q

Other types of buffers?

A

Phosphate buffer system
Protein buffers
Hemoglobin

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8
Q

pH normal level

A

7.35 - 7.45

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9
Q

Serum bicarbonate normal level

A

24-28

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10
Q

HCO3 : H2CO3 ratio

A

20:1

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11
Q

How does respiratory maintain balance?

A

Increase respiratory drive to eliminate C02 when body senses acute increase in CO2

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12
Q

How does renal maintain balance?

A

Regulating HCO3 levels

Responsible for eliminating most metabolic acids

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13
Q

First line of defense?
Within what time period?
Action?

A

Buffers
Seconds
Remove or release H+

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14
Q

Second line of defense?
Within what time period?
Action?

A

Lungs
Seconds to minutes
Elimination or retention of CO2 (Hyper/hypo ventilation)

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15
Q

Third line of defense?
Within what time period?
Action?

A

Kidneys
Hours to days
Retention of HCO3, Reduction of fixed acids and elimination of H+

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16
Q

Acidemia is?

A

pH is less than 7.35

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17
Q

Acidosis is?

A

Increase in H+ (acid) or loss of base

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18
Q

Alkalemia pH is?

A

pH greater than 7.45

19
Q

Alkalosis is (H+ and base)?

A

decrease in H+ (acid) or increase in base

20
Q

Respiratory acidosis: Lab findings

pH, PaCO2, HCO3, Electrolytes

A

pH less than 7.35 (DOWN) with PaCO2 greater than 45 mm Hg (UP)
HCO3: less than 22 (DOWN)
Elevated K+ : exchange of intracellular K+ for H+

21
Q

Causes of acute respiratory acidosis

A 
Ventilation failure 
Chest trauma 
Aspiration 
Pneumonia 
Sedative/narcotics
Airway obstruction 
Drug overdose
22
Q

Causes of chronic respiratory acidosis

A

Asthma
Cystic fibrosis
Multiple sclerosis
COPD

23
Q

Metabolic Acidosis: Lab Findings

pH, HCO3, CO2, Electrolytes, EKG

A 
pH less than 7.35 (DOWN)
HCO3 less than 22 mEq/L (DOWN)
CO2 less than 38 (DOWN)
Elevated K+ : exchange of intracellular K+ for H+
Dysrhythmias
24
Q

Metabolic Acidosis: Causes

A
  • Loss of HCO3 from diarrhea, draining fistulas, and TPN
  • Increase in Cl-
  • Ketoacidosis: diabetes, alcoholism, and starvation
  • Respiratory or kidney failure
  • Ingestion of toxins or drugs
  • Lactic acidosis
25
Q

Respiratory Acidosis: Manifestions

A

Cerebral vasodilation: HA, blurred vision, irritability, AMS
Warm, flushed
Tachycardia

26
Q

Chronic Respiratory Acidosis: Manifestions

A 
Dull HA
Impaired memory 
Personality change
Weakness
Sleep disturbance, daytime sleepiness
27
Q

Respiratory Acidosis: Interventions

A

Multidisciplinary
Emergency
COPD: Limit O2 administered

28
Q

Metabolic Acidosis: Manifestations

A

CNS: Headache, confusion, and drowsiness
Increased respiratory rate and depth (compensation)
N/V
Decreased BP
Decreased cardiac output and bradycardia (when pH 7.0)

29
Q

Metabolic Acidosis: Interventions

A

Collaborative
- Treat underlying cause: diabetes, diarrhea
- Administer HCO3
- Treat electrolyte abnormality (K+)
Independent
- Safety precautions if confused
- Monitor S/S of worsening (changes in resp, cardiac, CNS)
- Monitor lab results (ABG, Electrolytes)

30
Q

Respiratory Alkalosis: Lab Findings

ABG, Electrolytes, EKG

A

pH greater than 7.45 (UP)
PaCO2 less than 35 (DOWN)
Elevated K+
Dysrhythmias

31
Q

Respiratory Alkalosis: Causes

A 
Hyperventilation 
Altitude 
Anxiety 
Stimulation of hypoxemia: resp disorders
CNS lesions 
Fever (increase of metabolic needs)
Hypoxia 
Salicylate overdose
32
Q

Respiratory Alkalosis: Manifestations

A 
CNS: headache, confusion, and drowsiness
Increased respiratory rate and depth 
N/V 
Decreased BP
Decreased cardiac output 
Bradycardia 
Neuromuscular excitability
33
Q

Respiratory Alkalosis: Interventions

A 
Collaborative
- Treat underlying cause 
Independent 
- Relaxation 
- Treat underlying cause
34
Q

Metabolic Alkalosis: Lab Findings

ABG, Electrolytes

A

pH greater than 7.45 (UP)
HCO3 greater than 28 (UP)
Decreased K+
Decreased Cl-

35
Q

Metabolic Alkalosis: Causes

A 
Excessive H+ loss through vomiting or gastric suctioning 
Excessive use of K+ wasting diuretics 
Excessive adrenal corticoid hormones:
- Cushings 
- Hyperaldosternism 
- Excessive HCO3 intake
36
Q

Metabolic Alkalosis: Manifestations

A 
Confusion, AMS
Hyperreflexia 
Tetany 
Dysrhythmias
Hypotension 
Seizure
Respiratory failure
37
Q

Metabolic Alkalosis: Interventions

A

Collaborative

  • Administer O2, K+, Cl-
  • Treat underlying problem

Independent

  • Monitor I&Os, VS, LOC, Resp.
  • Electrolytes
38
Q

Nursing Assessment for Alkalosis/Acidosis

A

Health history of imbalances
Baseline vitals: ABG, serum electrolytes, serum CO2 and HCO3 levels, gluclose
Assess S/S

39
Q

Where can ABG labs be drawn from?

Performed by?

A

Artery (radial or femoral)

Respiratory therapist or by RN through arterial line

40
Q

Whats the Allen test?

A

Pressure is applied over the ulnar and the radial arteries so as to occlude both of them

41
Q

Compensation: Compensated

A

pH is NORMAL

PaCO2 and HCO3 ABNORMAL

42
Q

Compensation: Partially Compensated

A

pH is ABNORMAL

Both PaCO2 and HCO3 ABNORMAL

43
Q

Compensation: Uncompensated

A

pH is ABNORMAL

Either PaCO2 and HCO3 ABNORMAL

Med/Surg 1 Exam 1 (5 decks)

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