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Concepts Exam 3 > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

What mechanisms control bloods acid base balance?

A

Lungs

Kidneys

Buffer systems

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2
Q

How does the lungs help with acid base balance?

A

Release of CO2 from the lungs because CO2 is mildly acidic

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3
Q

Faster and deeper breathing results in what?

A

More CO2 released

Blood pH increases

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4
Q

How do kidneys helps with acid base balance?

A

Excretion of excess acids and bases affect blood pH

Kidneys have some ability to alter the amount of acid or base that is excreted

This compensation takes several days

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5
Q

What are the 3 buffer systems that help maintain pH?

A

Carbonic acid - sodium bicarbonate

Phosphate system

Protein system

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6
Q

What is the ratio of carbonic acid to sodium bicarbonate?

A

1:20

20 parts of sodium bicarbonate to 1 part of carbonic acid

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7
Q

Normal pH value?

A

7.35-7.45

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8
Q

What is PaCO2

A

Partial pressure of the CO2 dissolved in the blood

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9
Q

Value for PaCO2?

A

35-45 mm Hg

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10
Q

What is ABG?

A

Arterial blood gas

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11
Q

What is step 1 for interpretation of an ABG test?

A

Determine if patient is acidosis or alkalosis

<7.39 acidotic

7.40 normal pH

> 7.41 alkalotic

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12
Q

What is the 2nd step in interpreting an ABG

A

Is it respiratory or metabolic?

If it’s respiratory CO2 and pH will always be opposite

If it’s metabolic.. pH and bicarb will go in the same direction

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13
Q

What is the last step in interpreting ABGs?

A

Hypoxia presents?

Look at the PaO2 and O2 sat

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14
Q

What causes respiratory acidosis?

A

Hypo ventilation from any cause like myocardial infarction, cardiac arrest, CHF, aspiration

Pneumonia

Pulmonary edema

COPD

Any medication that depresses the respiratory rate

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15
Q

What are the signs and symptoms of respiratory acidosis?

A

Decreased LOC, confusion, lethargy

Tachycardia, palpitations

Flushed skin

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16
Q

How do you treat respiratory acidosis?

A

Improve ventilation
- Oxygen if needed

Pharmacologic therapies

Non-invasive positive pressure ventilation
-CPAP
-BiPAP

intubation and mechanical ventilation

17
Q

What causes respiratory alkalosis

A

Hyper ventilation

Extreme anxiety

Early sepsis

High fever

18
Q

Signs and symptoms of respiratory alkalosis

A

Lightheadedness, dizziness, confusion

Dry mouth, heart palpitations

19
Q

How do you treat respiratory alkalosis?

A

Aimed at treating the underlying cause

Encourage patient to slow their breathing

Breathing into a paper bag

Sedatives

20
Q

What is an anion gap?

A

The difference between the primary measured cations (Na and K) and the primary anions (Cl and HCO3)

Range from 3-11 mEq/L

21
Q

What could be the reason for an increased anion gap?

A

DKA

Renal failure

Uremia

22
Q

What could be the reason for a decreased anion gap?

A

Hypoalbuminemia

Bromide intoxication

Plasma cell dyscrasia

23
Q

What causes metabolic acidosis?

A

DKA
- high anion gap

Renal failure

Lactic acidosis

Toxins
-high anion gap

Severe diarrhea
-normal anion gap

Hyperalimentation (TPN)
- normal anion gap

24
Q

Signs and symptoms of metabolic acidosis

A

Headache, confusion, drowsiness

N/V

Tachypnea

25
Q

Treatment for metabolic acidosis

A

Aimed at treating underlying cause of the metabolic deficit

Pharmacologic therapy
-NaHCO3 use cautiously in high anion gap

Renal failure
-dialysis

26
Q

What causes metabolic alkalosis?

A

Vomiting

Prolonged gastric suctioning

Potassium wasting diuretics (hypokalemia)

27
Q

Signs and symptoms of metabolic alkalosis

A

Headache

Weakness, lethargy

Neuromuscular problems
- Seizures, tetany, delirium

28
Q

How do you treat metabolic alkalosis?

A

Aimed at treating underlying cause

0.9% NaCl IV administration

Correct hypokalemia

Correct hypovolemia

Acetazolamide (Diamox) PO or IV

Hydrochloric acid IV

Dialysis in severe alkalosis (>7.6)

29
Q

Normal values for bicarbonate?

A

HCO3 = 22-26 mEq/L

30
Q

Normal value for PaO2

A

80- 100 mmHg

Concepts Exam 3 (6 decks)

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