Acid- Base balance Flashcards
Major lung chemical
CO2 —- which is an acid!
kidney chemical
bicarb and hydrogen
normal pH range
7.35-7.45
Kidneys:
Remove acid through ___.
Bicarb? _____ OR _____
Kidneys take _______ to do their job.
urine
hold on to OR excrete in urine
hours to days… SLOW
Lungs: one way to get rid of CO2 is \_\_\_. Hypoventilation:\_\_\_ Hyperventilation:\_\_\_\_ Lungs respond \_\_\_\_.
?
Retain Co2
Eliminate Co2
FAST
NORMAL LAB VALUES: pH: PaO2: PaCO2: HCO3:
ph 7.35-7.45
pao2 80-100
paco2 35-45
hco3 (bicarb) 22-26
RESPIRATORY ACIDOSIS:
- is this a lung or kidney problem?
- what chemical is causing this problem?
- do we have too much or too little of this chemical in the body?
- hypoventilating or hyperventilating?
- what is going to compensate?
- how? with what chemical?
- the body must ____ the acid.
- the body will retain ____.
- is the ph high or low?
- lung problem
- CO2
- TOO MUCH
- hypoventilating
- kidneys will compensate
- bicarb and hydrogen
- excrete
- bicarb (get rid of hydrogen)
- LOW
causes of respiratory acidosis?
retain CO2
mid abdominal incision, narcotics, sleeping pills, pneumothorax, collapsed lung, pnuemonia
s/s of respiratory acidosis
headache, confused, sleepy
if not corrected, could lead to COMA
hypoxic (give them oxygen!)
early sign and symptoms of hypoxia?
tachycardia and restlessness
restlessness think ___ FIRST
hypoxia
increase CO2—____ LOC
increase CO2—____ O2
CO2 and O2 have ____ relationship!
DECREASE
DECREASE
INVERSE
Treatment for respiratory acidosis
- fix the breathing problem
- treat pneumonia, get rid of secretions, percussion, deep breathing exercises, suctioning, fluids, elevate HOB, incentive spirometry
- pneumothorax will have chest tubes!
- encourage post-op clients to turn, cough and deep breath
RESPIRATORY ALKALOSIS: What organ is sick? which organ is going to compensate? kidneys excrete \_\_\_ and retain \_\_\_. problem chemical? gaining or losing CO2? hypoventilating or hyperventilating? ph?
lungs are sick kidneys will compensate excrete bicarb and retain hydrogen CO2 losing CO2 hyperventilating high ph!
causes of respiratory alkalosis
hyperventilation
hysterical
acute aspirin overdose
the hysterical and asa overdose pts is breathing too fast and therefore removing CO2.
s/s of respiratory alkalosis
lightheaded, faint, peri-oral numbness, *numbness and tingling in the fingers and toes
(vasoconstriction)
treatment for respiratory alkalosis
- do not wait on the kidneys to kick in
- breath into a paper bag
- may have to ask client to decrease respiratory rate
- treat the cause
- monitor ABGs
METABOLIC ACIDOSIS: What organ is sick? what organ is going to compensate? with what chemical ? problem chemical? pt is retaining \_\_\_ or does not have enough \_\_. ph? respiratory rate will \_\_\_.
kidney is sick
lungs will compensate
co2
bicarb and hydrogen are the problem
retaining hydrogen. does not have enough bicarb.
LOW
increase (to exhale and get rid of CO2 to drop the acid level)
causes of metabolic acidosis
- DKA
- Starvation
- renal failure
- severe dirrehea
With DKA and starvation, the cells are starving for glucose, so the body will break down protein and fat, and produce ketones. ketones are acid.
s/s of metabolic acidosis
- depends on the cause
- hyperkalemia ( muscle twitching , muscle weakness, flaccid paralysis, and arrthymias)
- increased respiratory rate
treatment for metabolic acidosis
- treat the problem
- IV sodium bicarb ( helps acidosis, it will adjust the ph so you can figure out the problem)
METABOLIC ALKALOSIS: what organ is sick? what organ is going to compensate? with that chemical? problem chemical? the client is an alkalosis, so they are retaining too much \_\_\_\_ and excreting \_\_\_. ph?
kidneys are sick lungs will compensate bicarb and hydrogen too much bicarb and excreting hydrogen HIGH
causes of metabolic alkalosis
- loss of upper GI contents
- too many antacids… too much base
- too much IV bicarb
s/s of metabolic alkalosis
- depends of the cause
- observe LOC
- monitor for muscle cramps and life threatening arrthymias
treatment for metabolic alkalosis
- fix the problem
- replace potassium
serum potassium will go ____ in metabolic acidosis and go ____ in metabolic alkalosis.
UP
DOWN
Metabolic acidosis=
hyperkalemia
metabolic alkalosis =
hypokalemia