acid-base balance Flashcards
pH 7.35-7.45
PCO2 35-45 mmHg
HCO3 24-28 mEq/L
PO2 75-100 mmHg
ABG’s
3 systems work together to maintain pH with in a normal range; buffer system, respiratory system, and renal system
3 systems work together to maintain pH
bodys’ 3 major buffer systems
bicarbonate-carbonic acid buffer
Phosphate buffer
protein buffer
The bicarbonate-carbonic acid system gains a H ion if the pH is more than 7.35, and drops an H+ ion if the pH less than 7.45
acid base balance Acidosis/Alkalosis
the phosphate buffer system acts as a
strong ECF
the protein buffer system acts as a
ICF buffer
The respiratory system helps to maintain acid-base balance by adding CO2 if the pH is less than 7.45 or drops CO2 if the pH is more than 7.35
acid base balance Acidosis/Alkalosis
the renal system helps to maintain acid-base balance by excreting the H ion and retains HCO3 in acidosis and retains the H ion and excrete HCO3 in alkalosis.
acid base balance Acidosis/Alkalosis
a condition that results when PCO2 falls below 35mmHg.
Hypocarpnia
deep, rapid respirations assoc. with compensatory mechanisms
Kussmaul breathing
body is deprived of o2
Hypoxia
when compensatory mechanisms are unable to maintain the normal ration of bicarbonate to carbonic acid in the blood plasma even though the bicarbonate level is decreased or the carbon dioxide level is elevated.
Uncompensated
an actual or relative increase in the acidity of blood due to an accumulation of acids or an excessive loss of bicarbonate. The hydrogen ion concentration of the fluid is increased, lowering the pH.
Acidosis & Alkalosis
provides an indication of oxygen and carbon dioxide exchange and acid-base balance within the blood
ABG’s
occurs when pH drops below 7.35
acidosis
occurs when the pH rises above 7.45
Alkalosis
determined if the PaCO2 is less than 35 mmHg (alkalosis) or greater than 45 mmHg (acidosis)
A Primary Respiratory problem
When the HCO3 is less than 22 mEq/L (acidosis) or greater than 26 mEq/L (alkalosis)
A primary metabolic problem
Regulates the carbonic acid by eliminating or retaining carbon dioxide. CO2 is a potential ACID. (when gains a H+)
Respiratory System
Responsible for the long-term regulation of acid-base balance. the Kidneys eliminate excess non-volatile acids producing during metabolism. Renal tubules reg by breaking down carbonic acid
Renal system
Common Causes:
increased Acid production
-DKA, (ketoacidosis); Starvation, alcoholism, vomitting, Lactic acidosis; muscles fatigued
-Decreased acid excretion
Renal Failure;
-Increased Bicarbonate Loss (HCO3); too much normal saline can send you into an acidodic state.
Excessive diarrhea too
Metabolic Acidosis Causes
Decreased appetite (anorexia), nausea vomiting, abd pain
bradycardia, dysrhythmias, CNS dysfunction
-Kussmauls dyspnea; deep labored breathing
-Weakness, Fatigue, general malaise, HA
-Decrease LOC, Confusion
-hyperkalemia: shift of acid to ICF and K to the ECF
-warm, flushed skin
-headache, diarrhea, tremors
Laxatives; poop out your base; become Acidosis
Clinical symptoms of Metabolic Acidosis
Monitor ABG’s and I&O’s
Monitor LOC
-position patient to facilitate effective breathing
Nursing Interventions for Metabolic Acidosis
Increased Acid loss or secretions Vomiting or NG tube increased use of non K sparing diuretics -Lasix Increased adrenal corticoid hormones; increased HCO3 excessive intake
Eating Tums; alkalodic buildup of bicarb
Metabolic Alkalosis
common causes
Decreased LoC, confusion seizures HA Hyperreflexia, Tetany; muscle shakes Neuromuscular excitability Dysrhythmias, hypotension Respiratory Failure BP drops
Clinical symptoms of Metabolic Alkalosis
Monitor ABG's K Monitor I&O's VS LOC
Nursing Interventions for Metabolic Alkalosis
Treat the underlying cause
IVF’s
O2
Treatment for Metabolic Alkalosis
IV NaHCO3 (sodium bicarb) Treat the underlying cause
Treatment for Metabolic Acidosis
Impariment of alveolar gas exchange, acute pulmonary edema, pnemonia, asthma, cystic fibrosis, Chronic COPD stroke, MS Chronic Lung Disease Brain Injury Airway Obstructioin Mechanical Injury
Common Causes of Respiratory Acidosis
Increased PaCo2; HCO3 is normal or less with renal compensation
-vasodilation, cardiac dysrhythmias,
tachycardia, somnolence, decreased ventilation
opiate overdose
Clinical Manifestations for Respiratory Acidosis
Assess Respiratory status LOC I&O's VS ABG's
Nursing Interventions for Respiratory Acidosis
Admin inhalation therapies Bronchodilators ABX Narcotic Agonist; Narcan Percussion Postural Drainage Maintain adequate hydration
Treatment for Respiratory Acidosis
Extreme anxiety Panic attacks; over ventilating Increased body temp, fever Over ventilted hypoxia Salicylate overdose Brain Stem injury
Common Causes of Respiratory Alkalosis
Dizziness nausea, vomitting, tingling of extremities and/or mouth palpitations, chest tightness dyspnea Anxiety/panic Tremors/Tetany Seizures/ LOC
Clinical Symptoms of Respiratory Alkalosis
Monitor ABG's VS Vent settings Encourage slow breath Teach stress reduction techniques
Nursing Interventions for Respiratory Alkalosis
Admin Sedatives/antianxiety meds
O2
Maintain fluid status
Treatment for Respiratory Alkalosis
Volatile acid in the body; can be eliminated as gas
Carbonic acid H2CO3 separates in H2O and CO2
