Acid-Base Balance Flashcards

(51 cards)

1
Q

Normal pH of bloodsss

A

7.35-7.45

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2
Q

____________ respiration is what happens when you breathe oxygen into your lungs and breathe out CO2 and H2O (as vapour).

A

external

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3
Q

____________ respiration is what happens at the tissue level when the arterial capillary beds allow the diffusion of O2 into the cell and the venule capillary beds release CO2 into the plasma for return back to the lungs.

A

Internal

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4
Q

Normal cellular metabolism produces biproducts that make the body more

A

Acidic

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5
Q

3 systems that maintain acid base

A

Buffer (quickest)
Resp system (minutes)
Renal system (slowest) - days

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6
Q

buffer system

A

Occuring immediately

Takes CO2 and H2O making carbonic acid

If there are too many hydrogen ions (to acidic) they can be exchanged for potassium ions and if there are too few hydrogen ions, K+ are absorbed out of blood and H+ are added in (Vis versa)

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7
Q

Resp systems responds

A

In minutes, max effect is in hours

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8
Q

What does the buffer system often result in electrolyte wise

A

Alkalosis = hypokalemia
Acidosis = hyperkalemia

During acidosis, if kidneys cannot fix imbalance, the single charge Hydrogen must be put into the cells to get it out of the blood stream, and is exchanged

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9
Q

How do lungs contribute to acid base balance

A

Rapid respirations
exhalation of CO2
decreased acidity

Slow respirations
retention of CO2
increased acidity

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10
Q

How do kidneys contribute to AB regulation

A

Excretion or retention of acids and bicarbonate (HCO3)

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11
Q

Primary regulatory mechanism (Formula)

A

H2O + CO2-  H2CO3  HCO3- + H+

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12
Q

What is the balance of CO2 to bicarb to keep the body in a homeostatic state

A

1 part H2CO3 (Carbon dioxide + H2O)

20 parts HCO3 (Bicarbonate)

Hendersin-hasselcanlch relationship

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13
Q

What determines what type of acidosis/alkalsosis

A

Respiratory (lungs)
metabolic (kidneys)

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14
Q

What causes respiratory acidosis

A

Anything that causes hypoventilation, for example:
COPD
barbituate or sedative overdose
severe pneumonia
Atelectasis
Respiratory muscle weakness
mechanical hypoventilation
MS, ALS

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15
Q

Manifestations of resp acidosis

A

Drowsiness, headache, coma, disorientation

Decrease BP VFib, seizures, Dyspnea, hypoventilation with hypoxia

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16
Q

How is resp acidosis treated

A

Underlying cause must be treated

Nalaxone for drug overdose

Oxygen therapy (low flow)
Respiratory therapy

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17
Q

Causes of resp alkalsosi

A

Anything causing hyperventilation
2o to hypoxia, fear/anxiety, fever
Stimulated respiratory center
CNS disorders, sepsis, brain injury, salicylate poisoning
Mechanical overventilation

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18
Q

S/s of resp alkalosis

A

Lethargy, lightedheadedness, Increased HR, dysrythmias, tetany, n/v
Seizing forearms, hands

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19
Q

Resp alkalosis interventions

A

Treat underlying cause
Rebreather mask
Decrease anxiety
O2 if hypoxia is cause

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20
Q

Causes of metabolic acidosis

A

Accumulation of acid
diabetic ketoacidosis, septic shock (lactic acid accumulation), starvation
Loss of bicarbonate
-diarrhea, renal failure

Decrease in Bicarbonate, decrease in pH

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21
Q

Manifestations of metabolic acidosis

A

Deep rapid breathing, N/V, abdom pain, diarrhea, decrease in BP, dysrythmias periph vasodialation, drowsiness, confusion, headache

22
Q

Interventions for metabolic acidosis

A

Treat underlying cause
Respiratory support
Administer sodium bicarbonate (If serious)

23
Q

Metabolic alkalosis

A

Loss of acid
NG suctioning, prolonged vomiting, loss of K+ due to diuretic therapy
Gain in bicarbonate
Ingestion of baking soda

24
Q

Manifestations of metabolic alkalosis

A

Dizziness, irritability, nervousness, confusion, tachycardia, dysrythmias, anorexia, nausea, vomiting, hypoventilation

25
Intevention for metabolic alkalosis
Treat underlysing cause Replace lost fluids and elctroltes support renal fucniotn admin acetazolamide - promotes loss of bicarb in urine
26
10 marks on ABG interpretation of MT
27
pH is basically measureing amount of
Hydrogen
28
98.5% of O2 in blood is carried attatched to
Hem
29
What is the change in chemical bonds from cells in blood to lungs
H+ + HCO3 (Hydrogen and bicarb) H2CO3 (Carbonic acid) H2o + CO2
30
Renal system time to response
2-3 days, some level of response within 24 hours Can maintain balance for long period of time
31
High CO2 in the blood causes *
Acidity
32
ABG range for survival
6.8-7.8
33
Bicarbonate ions are
A weak base
34
H2CO3 is
Carbonic acid is A strong acid
35
COPD cause of acidosis?
Scarring in lungs, therefore NOT proper diffusion of gas across aveolar membrane CO2 is retained bc it is not easily exchanged across aveolar
36
How to reverse resp alkalosis
Breathing into paper bag
37
Why are NGs set to low intermittant suction
Too avoid causing metabolic alkalosis
38
ABG
Arterial Blood gas test
39
PaO2 and normal level
Partial pressure of free floating oxygen in blood Normal is 80-100 mmHg
40
Hypoxemia
Low oxygen IN the blood Low PaO2
41
Step by step approach to ABG
pH - too high or low PaCO2 level (representing acid) - Is there respiratory compenent Assess HCO3 (Kidney system) - Is there a metabolic component Does the PaCO2 or HCO3 match with the pH alteration Identify PRIMARY disorder
42
As pH goes up CO2 goes
DOWN
43
As pH goes up HCO3
Goes Up
44
Uncompensated means
Opposite system (Lungs for kidneys or vis versa) has not kicked in yet If pH is low with a high paCO2 but Bicarb levels are normal, this would be uncompensated resp acidosis
45
Normal ABG values
pH 7.35 – 7.45 PaO2 80 – 100 mmHg PCO2 35 – 45 mmHg HCO3- 22 – 26 mEq/L
46
Partially compensated
Both systems, metabolic and resp are working to restore pH, but pH is STILL currently outside of homeostatic range
47
Fully compensated
pH is normal, but resp and metabolic compensatory buffer systems are working in opposite directions
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