Acid-Base Balance Flashcards
What are 3 MAJOR CHEMICALS in Acid-Base balance?
- Bicarb - Base 2. Hydrogen - Acid 3. C02 - Acid
What is the major LUNG chemical?
CO2 –> ACID
What are the major KIDNEY chemicals?
- Bicarb –> Base and 2. Hydrogen –> Acid
What 2 things do these chemicals make you do?
Chemicals can either make you SICK or COMPENSATE. It depends on which IMBALANCE you have.
What is pH?
A measure of acidity or alkalinity of water soluble substances (pH stands for ‘potential of Hydrogen’). Range goes from 0 to 14 with 7 being neutral.
What 3 specific things does the pH tell you about the blood?
If the blood is: 1. Acidic 2. Alkaline or 3. Neutral
What is the normal pH range?
7.35 - 7.45
What term is used if the pH is below 7.35?
Acidosis Serious! A person can go into a coma and die.
What term is used if the pH is above 7.45
Alkalosis Makes nervous system become excited, which can lead to convulsions, and even death. If the pH is messed up, it can be dangerous. The BRAIN doesn’t like it, when the pH is messed up.
What 2 compensating organs does the body use to keep the pH within normal range?
Kidneys & Lungs
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How do the KIDNEYS compensate?
The kidneys will excrete excess Hydrogen Ions (which are acid) in the urine, OR they will retain the hydrogen ions if the body needs acid. 1. Remove acid through URINE 2. Bicarb - HOLD on or EXCRETE Kidneys control bicarb in the same way. Kidneys take hours to days to do their job. SLOW!
How do the LUNGS compensate?
One way to get rid of CO2 –> EXHALE! Hypoventilation: RETAIN CO2 Hyperventilation: ELIMINATE CO2 Lungs respond FAST!
What is Respiratory Acidosis?
Respiratory acidosis, also called respiratory failure or ventilatory failure, is a condition that occurs when the lungs can’t remove enough of the carbon dioxide (CO2) produced by the body. Excess CO2 causes the pH of blood and other bodily fluids to decrease, making them too acidic.
Which organ can be a problem in Respiratory Acidosis?
The LUNGS. Because it’s respiratory.
Respiratory Acidosis can be acute or chronic.
Since the client has a lung problem, which chemical is causing the problem?
CO2
In Respiratory Acidosis, since CO2 is the problem, is there too much, or too little of this chemical in the body?
Too much!
In Respiratory Acidosis, are you hypoventilating, or hyperventilating?
Hypoventilating. Breathing TOO SLOW. That’s why they’re retaining CO2. And CO2 is an acid.
In Respiratory Acidosis, what organ is going to help fix the problem, or compensate? How? With what chemicals?
KIDNEYS.
Bicarb & Hydrogen.
In acidosis, what is the body trying to become?
Less acid. So the body must EXCRETE the Acid.
In other words, get rid of HYDROGEN. Remove it from the body. Because Hydrogen is the ACID the KIDNEYS control.
The body will retain Bicarb.
Again, *EXCRETING HYDROGEN, RETAINING BICARB.*
Is the pH too high or low in Respiratory Acidosis?
LOW.
What are the normal lab values and testing strategy in the Respiratory Acidosis section?
What are the causes of Respiratory Acidosis?
1. Retaining CO2
2. Mid Abdominal Incision
3. Narcotics
4. Sleeping Pills
(Narcotics and sleeping pills will depress respirations and cause pt. to RETAIN CO2.)
5. Pneumothorax
6. Collapsed Lung
7. Pneumonia
*Any LUNG problem with HYPOVENTILATION as a symptom, think RESPIRATORY ACIDOSIS!
*Any time you have a question about a client that has ABDOMINAL/abdominalplasty –> THINK RESPIRATORY ACIDOSIS!
*HYPOVENTILATION –> IMPAIRED GAS EXCHANGE –> Leads to Acidosis.
What are INITIAL signs/symptoms of Respiratory Acidosis?
- Headache
- Confused
- Sleepy
If not corrected, could lead to COMA!
What can the patient eventually become after the initial S/S? What are the 2 early signs of it?
HYPOXIC!
Give them OXYGEN.
1. Restlessness
2. Tachycardia
*TESTING STRATEGY: Restlessness - think HYPOXIA FIRST!
Describe the treatment plan for a patient in Respiratory Acidosis.
- Fix the BREATHING problem.
- Treat Pneumonia by getting RID OF SECRETIONS through:
- Postural Drainage
- Percussion (vibration therapy)
- Deep breathing exercises
- Suctioning
- Fluids
- Elevate HOB
- Incentive Spirometry
3. PNEUMOTHORAX client will have CHEST TUBES.
- Encourage post-op clients to TURN, COUGH, and DEEP BREATHE.