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Nurse 158 > Acid Base > Flashcards

Acid Base Flashcards

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1
Q

What is the normal range for arterial blood pH

A

7.35-7.45

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2
Q

What is ABG stand for? What does it test?

A

Arterial Blood Gas

Tests for CO2, O2, pH

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3
Q

What are normal pH values for venous blood?

A

7.31-7.41

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4
Q

What are the four major changes that are caused by pH extremes

A
  • Hormones and enzymes denature
  • Shifts electrolytes causing F&E imbalances
  • Changes the excitability of membranes
  • Decreases the effectiveness of drugs and hormones
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5
Q

What are the three roles of the nurse r/t acid-base imbalance

A
  • Prevent disorders
  • Detect disorders
  • Know the interventions
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6
Q

What is the function of an acid?

A

It releases hydrogen when it dissolves in water

Donates hydrogen ion

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7
Q

What is the function of a base?

A

Binds to hydrogen when dissolved in water

Receives Hydrogen Iron

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8
Q

What type of acid is HCl? Give the formula

A

Strong

HCl + H2O H+ + Cl + H2O

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9
Q

What type of acid is Acetic acid? what is its formula?

A

Weak acid

CH3COOH + H2O H+ + CH3COO- + H2O

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10
Q

What is a buffer?

A

something that can accept/release hydrogen ions

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11
Q

What are the two classifications of buffer system?

A

Chemical and Physiologic

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12
Q

For every 1 point change in pH the substance has a concentration of H+ _____ times more/less than before

A

100

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13
Q

What is the lowest pH before death?

A

6.9

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14
Q

What is the highest pH before death?

A

7.8

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15
Q

What four things can lead to Metabolic Acidosis?

A
  1. Over production of H+
  2. Under-elimination of H+
  3. Unproduction of Bicarb
  4. Over elimination of Bicarb
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16
Q

What 3 things can cause an over production of H+?

A
  • Excessive breakdown of fatty acids
  • Anaerobic glucose breakdown (lactic acidosis)
  • Excessive intake of acids
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17
Q

Where does most H+ loss occur?

A

Lungs and Kidneys

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18
Q

What two things can cause under-elimination of H+?

A
  • Kidney tubules cant excrete H+

- Lungs retain CO2 which corresponds with H+ retention

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19
Q

What can cause underproduction of Bicarb Ions?

A

Impaired liver or pancreatic function

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20
Q

What is a base deficit?

A

a low bicarb level

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21
Q

What can cause an over-elimination of bicarbonate?

A

Diarrhea

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22
Q

What is the most influential base in the body

A

Bicarb

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23
Q

What buffer system is the first line of defense? This is also the strongest in the body

A

Chemical buffers

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24
Q

What are the three chemical buffer systems in the body?

A
  • Bicarb/carbonic acid
  • Phosphate buffer system
  • Protein Buffer system
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25
Q

The body likes to keep what ratio of Bicarb to acid?

A

20:1

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26
Q

The bicarb buffer system is tied to what body systems?

A

Respiratory and Renal

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27
Q

What is the formula for the Bicarb buffer system?

A

CO2 + H2O <> H2CO3 <> H+ + HCO3

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28
Q

What two things in the body are considered H+ sponges?

A

Bicarb and Phosphates

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29
Q

Where does the phosphate buffer system act?

A

In bothe the IFC and the EFC

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30
Q

Where does the phosphate buffer system occur the most?

A

in the renal tubules

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31
Q

What is the function of the phosphate buffer system?

A

To help excrete acid

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32
Q

What is the formula for the phosphate buffer system?

A

H+ + HPO4 <> H2PO4 (which can be excreted)

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33
Q

What proteins are used in the protein buffer system?

A

Hemoglobin, Albumin, and other globulins

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34
Q

the actions of the chemical buffers occur within _____

A

seconds

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35
Q

The two types of physiological buffers are?

A

Respiratory and Renal

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36
Q

What is the second line of defense buffer?

A

Respiratory

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37
Q

How fast does the respiratory buffer system kick in?

A

2-3 minutes

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38
Q

Unlike the chemical buffer system. respiratory buffer systems need _____ to kick in

A

Energy and effort

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39
Q

What is the main action of the respiratory buffer system?

A

To adjust ventilation in response to changing pH levels

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40
Q

Explain the process of the respiratory buffer system.

A
  • Medulla detects change in pH
  • changes respiratory rate
  • amount of CO2 is then adjusted via ventilation
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41
Q

The respiratory biffer system is ____ as effective than chemical

A

Twice

42
Q

What is the normal PaCO2 range?

A

35-45

43
Q

What is the most efficient buffer system?

A

renal

44
Q

How long does the renal system take to respond?

A

Hours

45
Q

What three actions do the kidneys take to buffer pH

A
  • Produce and regulate bicarb
  • Form acids
  • Form Bases
46
Q

What is the normal PaHCO3 range

A

22-26

47
Q

What are the 4 different acid base imbalances?

A

Metabolic and Respiratory Acidosis

Metabolic and Respiratory Alkalosis

48
Q

Metabolic issues cause _____ compensation

A

Respiratory

49
Q

Respiratory issues cause _____ compensation

A

Metabolic

50
Q

What is partial compensation?

A

pH remains abnormal

51
Q

What is full compensation

A

pH returns to normal

52
Q

When will the body overcompensate?

A

Never. We can cause the over compensation through drugs or holding our breath

53
Q

Anion gap is only relevant in ____ disorders

A

Metabolic

54
Q

What is actual acidosis?

A

The over production of acid or the under elimination of acid

55
Q

What is realative acidosis?

A

The amount or the strength of base decreases

56
Q

What caused actual acidosis?

A

Problems that increase acid production such as DKA and seizures
Problems that decrease acid elimination such as respiratory or renal impairment

57
Q

What are 4 causes of realitive acidosis?

A
  • Over elimination/underproduction of bicarb
  • Problems that cause underproduction of base(Pancreatitis or dehydration)
  • Problems that cause over elimination of base (diarrhea)
  • Increase of H+ or decrease of bicarb linked to K (AP is used up and decreased excitability)
58
Q

What is the anion gap?

A

the difference between anions and cations

59
Q

How is the anion gap calculated?

A

Na-(Cl + HCO3)

60
Q

What is a normal Anion gap?

A

8-16

61
Q

A high anion gap indicates ?

A

Metabolic Acidosis

62
Q

And low anion gap indicates

A

Metabolic Alkalosis

63
Q

What does the anion gap help us understand?

A

The underline cause of a compensation

64
Q

What are the main causes for an increased anion gap?

A

Lactic acidosis, keto acidosis, ingestion of toxins (Methanol, etheleneglycol)

65
Q

What does Base Excess tell us?

A

How much acid is required to return to normal

66
Q

What is normal range for base excess?

A

-3 to +3

67
Q

a high base excess indicates?

A

Metabolic alkalosis

68
Q

A low base excess indicates?

A

Metabolic Acidosis

69
Q

How do respiratory problems play into base excess?

A

They dont

70
Q

How does acidosis manifest in the body?

A

First in the musculoskeletal, cardiac, respiratory, and CNS.

71
Q

Even slight elevations in H+ can reduce the activity of _____

A

enzymes and hormones

72
Q

What happend to K during anabolism?

A

K goes into cells and leaves the ECF

73
Q

What happens to K during catabolism?

A

K leaves the cells as they break down and enters the ECF

74
Q

The anion gap is effected by changes in the _____

A

levels of H+

75
Q

The more H+ the _____ the anion gap

A

Higher

76
Q

What is respiratory acidosis?

A

When respiratory function is impaired, gas exchanges is reduced and pH goes up because CO2 is retained

77
Q

What four things can cause respiratory acidosis?

A
  • Respiratory depression
  • Inadequate chest expansion
  • Airway obstruction
  • Reduced alviolar-capillary disfusion
78
Q

What is respiratory depression and what causes it?

A

Depressed function of the respiratory center

  • Chemicals such as anesthetics, opioids, and poison
  • Physical damage to brainstem
79
Q

How does inadequate chest expansion cause acidosis? What are some causes for the inadequate expansion?

A

Reduced gas exchange from decreased volume

  • Deformities, weakness, constriction
  • obesity,scar tissue, and ascites
80
Q

What are some causes of reduced alveolar-capillary diffusion?

A
  • Pneumonia
  • Pneumonitis
  • TB
  • Emphysema
  • ARDS
  • Chest trauma
  • Drowning
81
Q

How is pH effected in acute resp. acidosis?

A

it is decreased

82
Q

How is pH effected in chronic resp. acidosis?

A

its normal

83
Q

Give me an example of a pt who whole have combined metabolic and respiratory acidosis?

A

COPD and DKA

84
Q

How does acidosis affect the cardiovascular system?

A

Arrhythmias due to hyperkalemia

85
Q

How does respiratory acidosis affect the cardiovascular system uniquley?

A

increased HR

86
Q

How does acidosis affect the CNS

A

Depression of function

87
Q

How does acidosis affect the Neuromuscular system?

A

Reduced muscle tone and DTR due to hyperkalemia

88
Q

How does metabolic acidosis affect the respiratory system?

A

causes rapid deep kussmaul respirations

89
Q

How does respiratory acidosis affect the respiratory system?

A

Shallow, rapid, SOB

90
Q

How does metabolic acidosis affect the skin

A

Causes vasodilation resulting in warmth, dry, and pink skin and MM’s

91
Q

How does respiratory acidosis present in the skin?

A

Cyanotic

92
Q

What are three signs of acidosis in adults?

A

Weakness, depression, disorientated

93
Q

A PaHCO3- of less than ____ is acidic

A

21

94
Q

In metabolic acidosis ___ and ___ are normal levels

A

CO2 and O2

95
Q

What are the interventions for metabolic acidosis?

A
  • Remove the cause
  • Restore fluids
  • Give drugs
96
Q

What are some drugs used to treat metabolic acidosis?

A
  • Insulin
  • Antidirrheal
  • Bicarb if pH is below 7.1 flush with NS before and after
97
Q

K levels are ___ in acute RA and ___ in chronic

A

Elevated

normal

98
Q

What are the interventions for Respiratory acidosis?

A
  • Maintain the airway
  • Enhance gass exchange
  • Give O2
  • Ventilation
99
Q

What are some causes of alkalosis

A
  • pH is too high
  • H+ is too low
  • Bicarb is too high
100
Q

How does alkalosis present itself?

A

-Overexcitment of the CNS, neuromuscular, and CV system

Nurse 158 (14 decks)

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