acid-base balance Flashcards
what is normal arterial blood pH range
7.35-7.45
what can abnormal pH lead to
death
what is acid-base balance regulated by
respiratory and renal mechanisms
describe how respiratory mechanisms regulate acid-base balance
rapid pH change due to quick diffusion of CO2 (minutes to hours)
describe how renal mechanisms regulate acid-base balance
regulate hydrogen ion excretion or retention and formation or excretion of bicarbonate ions
slower compensatory mechanism than respiratory (can take up to 3 days)
how is acid-base balance measured
ABGs
-frechly oxygenated blood
-partial pressure of the gases reflect the overall effectiveness of gas exchange
what is normal PaO2 range
85-95
what is normal PaCO2 range
35-45
what is noraml HCO3 range
22-26
what are some acid-base imbalances
-respiratory acidosis
-respiratory alkalosis
-metabolic acidosis
-metabolic alkalosis
each can be uncompensated, partially compensated, or compensated
clinical manifestations of metabolic acidosis
-kussmaul breathing
-capillary dilation (flushing of skin)
-dehydration
-ABD pain, n/v
pH = A
HCO3 = A
clinical manifestations of metabolic alkalosis
-shallow breathing
-tetany like sx
-confusion/irritability
-vomiting
pH = B
HCO3 = B
clinical manifestations of respiratory acidosis
-dyspnea/impaired gas exchange
-flushing, warm skin
-tachycardia/weakness
pH = A
CO2 = A
clinical manifestations of respiratory alkalosis
-rapid shallow breathing
-tetany like sx
-palpitations/vertigo
pH = B
CO2 = B
causes of metabolic acidosis
-severe infection
-diabetic acidosis
-tissue trauma
-shock
-renal failure
-heart failure
-severe diarrhea or starvation
causes of metabolic alkalosis
-hyperemesis
-gastric suctioning
-peptic ulcers
causes of respiratory acidosis
-pneumonia
-COPD
-chest injuries
-opioids
causes of respiratory alkalosis
-fever
-pain
-brain tumor
-anxiety
-drug toxicity
-excessive exercise
describe management of optimal acid-base balance (rapid but short term)
respiratory rate/depth regulates CO2
-huge surface area in lungs (alveolar and cap diffusion)
-cellular metabolism yields carbonic acis (as CO2 increases in blood, resp rate increases to reduce CO2 levels)
-respiratory management of acid base balance is rapid, but short term
describe management pf optimal acid-base balance - slower
-renal regulation og hydrogen ions and bicarb
-when pH is low, kidneys excrete H+ and retain HCO3
-retaining bicarb increases the pH of the blood
-renal regulation may take up to three days
describe the nusting process for acid-base balance
-assess resp rate and depth, cognitive function, dizziness
-interventions - altered resp rate, admin of O2, admin of bicarb
-eval - improved pH, resp rate/depth
a nurse carefully assess the acid-base balance of a pt whose HCO3 level is decreased. this most likely a pt with damage to the…
kidneys
