Acid-Base Balance Flashcards
What are the major chemicals?
Bicarb
H
CO2
What is the lung chemical; acid or base?
CO2, acid
What are the kidney chemicals; acid or base?
HCO3- Base
H- Acid
Compensating organs: Kidneys
Remove acid how?
Through urine
Compensating organs: Kidneys
What do they do with bicarb?
Hold on and return it to blood OR excrete through urine
Bicarb is a base–so it is held on when things are too acidic
Bicarb is a base–so it is let go of (excreted through urine) when things are too basic
Compensating organs: Lungs
What is one way to get rid of CO2?
Exhale
Compensating organs: Lungs
When you HYPOventilate are you retaining or eliminating CO2?
Retain Co2
Compensating organs: Lungs
When you HYPERventilate are you retaining or eliminating CO2?
Eliminating CO2
Compensating organs
What organ takes hours to days to compensate?
What organs take seconds to minutes?
Hours to days: Kidneys (efficient)
Seconds to minutes: Lungs (not as efficient)
Respiratory acidosis
What problem and what chemical causing problem?
Lung problem so CO2 causing it
Respiratory acidosis
Too much or too little CO2?
Too much
Respiratory acidosis
Hypo or hyperventilating?
HYPOventilating (person retaining CO2 so having too much of it)
Respiratory acidosis
Who compensates?
Kidneys with Bicarb and H
Respiratory acidosis
What does body do with H to compensate?
What does body do with Bicarb to compensate?
Too much CO2 (acid) so need to EXCRETE acid (H) and retain the Bicarb (base)
Respiratory acidosis
What is pH?
Low (acidosis)
Respiratory acidosis
Causes?
Anything that makes you retain CO2
- Incisions, narcotics, sleeping pills
- Pneumothorax, collapsed lung, pneumonia
*note: all these cause hypoventilation and/or impaired gas exchange
Respiratory acidosis
S/s?
- HA, confused, sleepy
- Can lead to coma
- Hypoxic
Respiratory acidosis
What are early s/s of HYPOXIA?
Restlessness and tachycardia
Respiratory acidosis
Restlessness think what first?
HYPOXIA!!!
Respiratory acidosis
If they are hypoxic, give them ___
O2
Respiratory acidosis
Tx?
Fix resp. problem
Tx pneumonia, get rid of secretions, do deep breathing, suction, give fluids, elevate HOB, incentive spirometry
Respiratory acidosis
T/F: Pneumothorax client will have chest tube
T
Respiratory acidosis
Encourage post-op clients to do what to help prevent resp. acidosis?
To turn, cough, and deep breathe!!
Respiratory alkalosis
What organ is sick? What organ compensates?
Sick: Lung
Compensate: Kidneys
Respiratory alkalosis
What do kidneys excrete to compensate?
What do they retain to compensate?
Excrete bicarb
Retain H
Respiratory alkalosis
Problem chemical?
CO2
Respiratory alkalosis
Gaining or losing CO2?
Losing!
Respiratory alkalosis
Hypo or hyperventilating?
Hyperventilating (this is why all acid (CO2) is leaving)
Respiratory alkalosis
pH?
High
Respiratory alkalosis
Causes?
- Hyperventilating
- Hysterical
- Acute aspirin overdose
*all these situations client is breathing too fast and removing the Co2
Respiratory alkalosis
S/s?
Lightheaded or faint feeling
Peri-oral numbness
Numbness and tingling in fingers/toes
Respiratory alkalosis
Tx?
- DO NOT wait for kidneys to compensate!!
- Breathe into paper bag
- Sedate client to decrease RR
- Treat cause
- Monitor ABG
Metabolic acidosis
What organ is sick?
Kidney
Metabolic acidosis
What organ compensates?
Lung, compensates with CO2
Metabolic acidosis
Problem chemicals?
Bicarb and H+
*the client is either retaining H+ making it too acidic or does not having enough bicarb (not having enough base to balance out)
Metabolic acidosis
pH?
Low
Metabolic acidosis
What happens with RR?
Increase (to get rid of acids)
Metabolic acidosis
What kind of respirations?
Kussmaul respirations
Metabolic acidosis
Causes?
- DKA and starvation —cells starve for glucose so body breaks down protein and fat, which produces ketones. Ketones are acids
- Renal failure
- Severe diarrhea (excreting too much base!)
Vomit acid or base?
Acids
Poop acid or base?
Base
Metabolic acidosis
S/s?
Depend on cause
HYPERkalemia
Increased RR
Metabolic acidosis
What are s/s of hyperkalemia?
Muscle twitching–> arrhythmias
Muscle weakness
Flaccid paralysis
Metabolic acidosis
Tx?
Treat problem
Give IV sodium bicarb (base) to help fix (temporary)
Metabolic acidosis
What is normal bicarb level?
22-26
Metabolic alkalosis
What organ is sick?
Kidney
Metabolic alkalosis
What organ is trying to compensate?
Lung with Co2
Metabolic alkalosis
Problem chemicals?
Bicarb and H
Metabolic alkalosis
The client is in alkalosis, so they are retaining too much ____ and excreting H
Bicarb
Metabolic alkalosis
What do upper GI contents have–acids or bases?
Acids
Metabolic alkalosis
What do antacids have–acids or bases?
Base
Metabolic alkalosis
What are some causes?
- Loss of upper GI contents (acids)
- Too many antacids (base)
- Too much IV bicarb (base)–like when you push a lot of bicarb with a code
Metabolic alkalosis
S/s
- Depend on cause
- Watch LOC
Metabolic alkalosis
What happens to serum K?
Decreases
Metabolic ACIDOSIS
What happens to serum K?
Increases
Metabolic alkalosis
Patient is hypo or hyperkalemic? What happens?
HYPOkalemic
Muscle cramps–life threatening arrhythemias
Metabolic ACIDOSIS
Patient is hypo or hyperkalemic? What happens?
HYPERkalemic
Muscle twitching (leads to arrhythmias), muscle weakness, flaccid paralysis
Metabolic alkalosis
Tx?
Fix problem
Replace K+
Metabolic acidosis= ?
Hyperkalemia
Metabolic alkalosis= ?
Hypokalemia