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NURS 312 > Acid & Base Balance > Flashcards

Acid & Base Balance Flashcards

1
Q

Intracellular fluid

A

Within the cells. Main component is potassium.

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2
Q

Extracellular fluid

A

Interstitial fluid. Main component is sodium. Excessive fluid causes peripheral/pulmonary edema. Intravascular fluid; plasma.

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3
Q

Sodium range

A

135-145 mEq/L

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4
Q

Chloride range

A

95-105 mEq/L

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5
Q

Potassium range

A

3.5-5.0 mmol/L

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6
Q

Total calcium range

A

8.0-10.5 mg/dL

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7
Q

Ionized calcium range

A

4.4-5.4 mg/dL (used for critically ill/injured pts)

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8
Q

Phosphate range

A

2.5-4.5 mg/dL

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9
Q

Magnesium range

A

1.8-3.0 mg/dL

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10
Q

BUN range

A

7-20 mg/dL

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11
Q

Creatinine range

A

0.8 to 1.2 mg/dL

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12
Q

HCO3 (95% CO2)

A

20-30 mEq/L

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13
Q

CO2

A

20-30 mEq/L

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14
Q

Elements of CHEM 7

A

Na (135-145)
K (3.5-5.0)
Cl (85-105)
HCO3 (20-30)
BUN (5-20)
Cr (0.8-1.5)
Glucose (60-120)

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15
Q

What do you add to make CHEM10?

A

Phosphate (2.5-4.5)
Magnesium (1.8-3.0)
Total calcium (8.0-10.5)

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16
Q

pH range

A

7.35-7.45 (7.4 neutral)

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17
Q

PaCO2

A

35-45 mm Hg

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18
Q

PaO2

A

80-100 mm Hg

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19
Q

HCO3-

A

22-26 mEq/liter

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20
Q

SaO2

A

> 94%

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21
Q

Where is arterial blood gas drawn?

A

Peripheral artery; central vein

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22
Q

Where is the venous blood (serum) drawn?

A

Central vein; peripheral vein

23
Q

Acid is a byproduct of

A

metabolism

24
Q

Volatile acid

A

H2CO3 (carbonic acid); equilibrium with dissolved CO2; eliminated by pulmonary system

25
Q

Non-volatile acid

A

Fixed acid; buffered by body protein or ECF buffers HCO3- (bicarbonate); eliminated by renal system

26
Q

Metabolic activities of the body…

A

require precise regulation of acid/base balance and are reflected by the pH of extracellular fluid

27
Q

Acid compound (acidosis)

A

Dissociate and release hydrogen ions.
H2O + Cl- = HCL (hydrochloric acid)

28
Q

Base compound (alkalosis)

A

Accepts or combines hydrogen ions.
HCO3- + H+ = H2CO3 (carbonic acid)

29
Q

pH

A

Negative logarithm (log10) of H+ concentration is expressed in mEq/L.
pH is inversely related to H+ concentration

30
Q

Causes of respiratory acidosis

A

Hypoventilation, slow & shallow respirations, apnea, severe respiratory congestion or secretions

31
Q

Effects of respiratory acidosis

A

Increased PaCO2, decreased pH (ROME)

32
Q

Mechanism of respiratory acidosis

A

Hypoventilation

33
Q

Clinical manifestations of respiratory acidosis

A

Headache, blurred vision, confusion, tremors, muscle twitching, irritability/lethargy/coma, tachycardia then bradycardia, BP fluctuations, diaphoresis

34
Q

Causes of respiratory alkalosis

A

Hyperventilation, pain or anxiety, fever/hypermetabolic states, hypoxia

35
Q

Effects of respiratory alkalosis

A

Decreased PaCO2, increased pH (ROME)

36
Q

Mechanism of respiratory alkalosis

A

Hyperventilation

37
Q

Clinical manifestations of respiratory alkalosis

A

Paresthesia, fingers/toes tingling/numbness, anxiety, tachycardia, dysrhythmias, muscle irritability/tetany, inability to concentrate/dizziness, seizures, dry mouth

38
Q

Causes of metabolic acidosis

A

Diarrhea, renal failure, diabetes ketoacidosis (DKA), tissue hypoxia and shock

39
Q

Effect of metabolic acidosis

A

Decreased bicarbonate, decreased pH (ROME)

40
Q

Mechanism of metabolic acidosis

A

Kidney reabsorbs hydrogen ions (if there are no renal issues) and excrete bicarbonate (HCO3-).

41
Q

Clinical manifestations of metabolic acidosis

A

Warm, flushed skin, Kussmaul respirations, diarrhea, hypotension, dysrhythmias, hyperkalemia, shock, coma

42
Q

Causes of metabolic alkalosis

A

Vomiting, nasal gastric suctioning, excessive antacid use

43
Q

Effects of metabolic alkalosis

A

Increased bicarbonate, increased pH (ROME)

44
Q

Mechanism of metabolic alkalosis

A

Kidneys excrete hydrogen ions (if there are no renal issues) and reabsorb bicarbonate (HCO3-)

45
Q

Clinical manifestations of metabolic alkalosis

A

Mental confusion, respiration depression, nausea/vomiting, hyperactive reflexes, dysrhythmias, paresthesia, tetany, seizures

46
Q

ABG analyzes…

A

carbon dioxide and bicarbonate levels

47
Q

Base excess/deficit (venous serum)

A

Normal level: +/- 2 mEq/L
Measures serum level of buffer system. Amount of fixed acid or base needed to achieve pH 7.4
Base excess = m. alkalosis
Base deficit = m. acidosis

48
Q

Anion gap (venous serum)

A

Normal level: 8 to 16 mEq/L
Measures sum of plasma cations and anions.
Na - (Cl+HCO3)
Increased lvl (metabolic acidosis): Lactic & ETOH acidosis
Decreased level (metabolic alkalosis): Hyperkalemia; hypercalcemia

49
Q

Lactic acid (venous serum)

A

Normal level: 0.5-2.2 mEq/L
Anaerobic metabolism; hypoxia, sepsis, excess physical activities, liver failure, uncontrolled diabetes mellitus

50
Q

Ketones (venous serum)

A

Presence of ketonemia or ketonuria. Use of fatty acids as an energy source (no glucose); ketoacidosis

51
Q

Interventions for metabolic/respiratory acid/base imbalances

A
  1. Stop hemorrhage
  2. Responsiveness
  3. Ventilation
  4. Oxygenation
  5. Perfusion (IV fluids, blood products, cardiopulmonary resuscitation (CPR)
    - Insulin for DM
    - Diet (protein is a source of non-volatile fixed acid)
52
Q

ROME

A

Respiratory Opposite (inverse relationship): Decreased pH –> increased CO2, increased pH –> decreased CO2

Metabolic Equal (proportional relationship): Increased pH –> increased HCO3-, decreased pH –> decreased HCO3-

53
Q

What ABG pH values are incompatible to life in long duration?

A

<6.8 or >7.8

NURS 312 (5 decks)

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