Acid Base Balance

Question 1

PH range

Answer 1

Amount of acid to base in blood (1carbonic acid to 20 base bicarbonate)

7.35-7.45

<7.35=acidosis
>7.45=alkalosis

Question 2

CO2

Answer 2

When CO2 is elevated think acid

35-45 normal

<35=acidosis
>45=alkalosis

Lungs control CO2

Question 3

Regulation of CO2

Answer 3

CO2 too high: respirations increase to “blow off” acid

CO2 too low: respirations decrease to hold onto acid

Lungs are quick to fix

Question 4

HCO3

Answer 4

Main base

22-26 normal

<22=acidosis

> 26=alkalosis

Regulated by kidneys

Question 5

Regulation of HCO3

Answer 5

HCO3 low: kidneys retain HCO3 or excrete acid

HCO3 high: kidneys excrete HCO3 or retain acid

Kidneys are slower to fix than lungs
(Metabolic parameters)

Question 6

Oxygenation
Pa02

Answer 6

Normal : 80-100 (95-100% sats)

Mild hypoxemia 60-80 (90-95% sats)

Moderate: 40-60 (75-90%)

Severe <40 (75% sats)

Question 7

Respiratory acidosis ***

Answer 7

PH <7.35
CO2>45mmHg

Inadequate elimination of CO2 by lungs
Retaining CO2

Question 8

Respiratory acidosis etiology ***

Answer 8

COPD

Respiratory muscle weakness

Head injury

Drug overdose, over sedation

Pneumothorax

Pneumonia, atelectasis

Question 9

Respiratory acidosis s/s ***

Answer 9

Restlessness
Coma
Seizures
Dysrhythmias from hyperkalemia

Question 10

Respiratory alkalosis ***

Answer 10

PH>7.45
CO2<35

Excessive elmination of CO2
“Blowing off CO2”

Question 11

Respiratory alkalosis causes ***

Answer 11

Hyperventilation due to:

Fear, pain, anxiety, fever

Question 12

Resp alkalosis s/s ***

Answer 12

Light headedness

Numbness/tingling

Tachycardia

Cardiac dysrhythmias drom hypokalemia

Question 13

Metabolic acidosis ***

Answer 13

PH<7.35
HCO3 <22

Too much acid
Not enough base

Question 14

Metabolic acidosis etiology ***

Answer 14

Increased acid:
Renal failure
DKA
Starvation
Hypoxia/shock

Loss of bicarbonate (base):
Diarrhea
Intestinal fistulas

Question 15

Metabolic acidosis s/s ***

Answer 15

Dysrhythmias r/t hyperkalemia

Kussmaul resp
*deep, rapid RR
Lungs trying to compensate

Question 16

Metabolic alkalosis ***

Answer 16

PH>7.45
HCO3>26

Too much base
Not enough acid

Question 17

Metabolic alkalosis etiology ***

Answer 17

Too much base:
Excessive use of bicarbonate
Excess ingestion of antiacids

Loss of acid:
Vomiting
NG suction
Diuretics

Question 18

Metabolic alkalosis s/s ***

Answer 18

Muscle twitching

Cramping

N/V

Hypoventilation-lungs trying to compensate

Question 19

Compensation ***

Answer 19

If the ph falls out of range and the body trys to return it to normal

2 systems try to do this:
Lungs and kidneys

Question 20

If the problem is respiratiory (CO2) what will compensate?

Answer 20

Kidneys (HCO3)

Question 21

If the problem is metabolic (HCO3) who will try to compensate?

Answer 21

LUNGS (CO2)

Question 22

Uncompensated ***

Answer 22

PH abnormal plus either CO2 or HCO3 are abnormal

Question 23

Partial compensation ***

Answer 23

PH, CO2, and HCO3 are all abnormal

Body has started compensating but havnt got PH back to normal

Question 24

What results will you see if its fully compensated

Answer 24

PH normal with CO2 and HCO3 abnormal

If when compensated the PH is:
7.35-7.39=acidosis
7.411-7.45=alkalosis

Question 25

ROME abbreviation ***

Answer 25

RO:
Respiratory opposite
PH and CO2 move in opposite directions

ME:
Metabolic equal
PH and HCO3 move in the same direction