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Med Surg > Acid/Base Balance > Flashcards

Acid/Base Balance Flashcards

1
Q

Stomach pH

A

1.5 - 20

Throwing up = alkolotic

losing acid

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2
Q

Colon pH

A

7.9-8.5

basic

losing base –> becoming acidic

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3
Q

what is ph?

A

potential hydrogen

hydrogen concentration –>

lower pH = more acidic, higher pH = more alkaloid

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4
Q

ROME

A

Resp opposite
Metabolic equal

acidic –> alkalotic
pH : 7.35 - 7.45
PaCO2 : 45 - 35
HCO3 : 22 - 26

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5
Q

what is a base and what is acid?

A

CO2 = acid –> because its carbonic acid

Hydrogen/ HCO3 = base

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6
Q

Chemical buffer system

A

First line of defense

immediate response

  • bicarbonate, phosphate, protein
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7
Q

Physiological buffer System

A

Second line of defense against imbalances

respiratory - minutes to hours ***

renal - hours to days **

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8
Q

What does Renal / HCO3 excrete?

A

H excretion!

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9
Q

what does respiratory excrete?

A

CO2 !

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10
Q

What is the most effective regulator of ph?

A

THE RENAL

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11
Q

What is O2?

A

% of oxygen that has hgb attached to it

ex: o2 sat is 98%, 2% of the blood doesnt have oxygen attached

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12
Q

Metabolic acidosis

A
  • Diarrhea
  • Increased RR (Kussmal) respiratory is trying to fix it and compensate!
  • N/V
  • decreased BP
  • cold skin
  • Dysrhythmia* –> hyperkalemia! we hold onto acid because we want to excrete K
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13
Q

Metabolic Acidosis - Cause

A
  • Kidney injury (cant release acid)
  • Diarrhea, intestinal fistula
  • increased Cl –> more negative ions! body tries to fix it by holding onto more hydrogen
  • DKA
  • Renal Failure
  • Lactic acidosis –> tissue hypoxia (cardiac arrest/shock)*
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14
Q

Metabolic acidosis TX

A
  • Give Bicarb
  • Watch potassium (usually hyperkalemia)
  • ECG for cardiac dysrhythmias
  • Serum Calcium levels (will be low)
  • Correct b4 treating acidosis
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15
Q

Anion gap

A

8- 12

sum of all positive minus all negative charged ions

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16
Q

Metabolic Alkalosis - Causes

A
  • Loss of acid
  • Vomit **
  • Gastric Suctioning **
  • ETOH
  • Excess Bicarbonate (PO) - antacid use or over correction w/ use in metaboloc acidosis
  • Hypokalemia –> kidneys hold onto K and secrete Hydrogen, K leaves cells and H goes into cells
17
Q

Metabolic Alkalosis

A
  • Vomiting
  • Decreased RR (resp compensation!!!) trying to hold onto acids
  • HYPOCALCEMIA** s/s - tingling of finger and toes, dizzy, hypertonic muscles**
  • Hypokalemia –> U wave, PVC
  • Decreased Motility
  • Paralytic ileus
18
Q

Metabolic alkalosis TX

A

correct underlying cause

restore normal K levels

NS** solutions

19
Q

Respiratory Acidosis - Cause

A

Acidoooosis = slow breathing , hypoooventilation

  • Sleep Apnea
  • Atelectasis
  • Pneumothorax
  • COPD, Cystic Fibrosis
  • Pulmonary Edema
  • Head Trauma
  • Post Surgery
  • ETOH
  • Alcohol intox
  • Impaired respiration - Muscular dystrophy, MS, Myasthenia gravis, Guillian Barre
  • Medications –> OPIOD, Benzo (lam + pam) – sedatives
20
Q

Respiratory Acidosis S/S

A

Hypoventilation –> hypoxia

Acute - inc RR, inc BP, confusion, dec LOC,

F dib - may be first sign of respiratory acidosis in anesthetsized pt’s

severe acidosis: increased ICP

Hyperkalemia

Chronic: emphysema and bronchitis, OSA, Obesity

21
Q

Respiratory acidosis TX

A

Improve ventilation

hypoxia often accompanies Resp acidosis

Restore gas exchange

ED and ICU - may need ventilation and slow CO2 level decrease

reverse opiods

22
Q

Respiratory Alkalosis Causes

A
  • Hyperventilation
  • Blowing off CO2
  • Extreme anxiety
  • Hypoxemia
  • Salicyte intox
  • gram negative bacteremia
  • Inapprop ventilator settings
  • Aspirin intox
  • Sepsis
23
Q

Respiratory Alkalosis S/S

A

hyperventilation

Low Ca level = nueromuscular excitability -> hyper reflexes, muscle cramps, numbness and tingling,

Low CO2 –> vacoconstriction of cerebral vessels –> increased LOC

  • Tinnitus
24
Q

Respiratory Alkalosis - TX

A
  • Breathe into PAPER BAG –> retain acid / co2**
  • Slow the breathing –> rebreating into a rebreather mask
  • Anxiolytic
  • Ventilation
25
Q

Metabolic disorders - compensation by respiratory

A

Respiratory change rate of breathing to restore pH

26
Q

Respiratory disorders - compensating by metabolic / kidneys

A

Kidneys conserve bicarb and eliminate H

27
Q

fully compensated

A

pH is restored to normal (7.35-7.45)

28
Q

Partial compensation

A

PH not WNL –> opposite system will try to compensate. opposite system is normal

Med Surg (1 decks)

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