acid base balance Flashcards
people want to breath so when respiratory acidosis is seen should mechanical ventilation be used
no treat symptoms first the body wants to breath as soon as it can
Respiratory alkalosis can be managed by doing what to ventilator
decreasing rate
metabolic acidosis with significant hyperkalemia should be treated with
Treat underlying cause
fluide reuscitation
HCO3
Patient wiht chronic renal failure with normal anion gap but metabolic acidosis is seen how to treat
treat with bicitra
When managing patient with metablic alkalosis with very low hypokalemia how do you manage
correct volume deficit and give KCL
D/C diuretics
h2 blockers in patients iwth GI loss
When managing patient with metablic alkalosis with contraindicated fluid replacement how do you manage
acetazolamide
With respiratory acidosis how long will it take for the renal compensatory mechanism to take effect
6-12 hours renal compensation will be activated but take several days to correct
respiratory acidosis results from decreased ventilation of
aveloli
Patient comes in with c/o of sleepiness, and headache. Says he feels confused and out of it lately. you notice flapping and twitching in hands, respiration look labored you suspect what metabolic issue
RESPIRATORY ACIDOSIS
1) somnolence and confusion
2) myoclonus with asterixis
3) increase cerebral blood flow leading to incerased icp
Patient comes in with c/o of sleepiness, and headache. Says he feels confused and out of it lately. you notice flapping and twitching in hands, respiration look labored you suspect what metabolic issue labs ph, pco2, hco3, and cl would look like
Respiratory acidosis ph less than 7.35 pco20 greater than 45 hco3 greater than 26 cl less than 93
Patient comes in with c/o of sleepiness, and headache. Says he feels confused and out of it lately. you notice flapping and twitching in hands, respiration look labored you suspect what metabolic issue Management of would include
Respiratory acidosis
assess for narcotis, Narcan (if no obvious cause)
Improve ventilation (possibly intubations)
increased rate on ventilator, once on ventilator
respiratory alkalosis causes clinical symptoms due to cerebral blood flow
decrease
management of respiratory alkalosis starts with treating
the underlying cause
if patient has respiratory alkalosis due to acute hyperventilation syndrome what would be done to manage
have patient breath into paper bag
If patient is on a ventilator and becomes respiratory alkalosis what could be done to treat
decrease rate of ventilation
possible sedate
Rapid correction of chronic alkalosis can lead to
metabolic acidosis
Patient comes in with complaints of light headedness, anxiety, tingling and numbness in right arm. Respiration is very rapid, you suspect what ph issue
Respiratory alkalosis
Patient comes in with complaints of light headedness, anxiety, tingling and numbness in right arm. Respiration is very rapid, you suspect what ph issue, labs for ph, pC02, Serum HCO3 look like
respiratory alkalosis
ph greater than 7.45
pco2 less than 35
hco3 greater than 26 if chronic issue
Patient comes in with complaints of light headedness, anxiety, tingling and numbness in right arm. Respiration is very rapid, you suspect what ph issue, you treat with
Respiratroy alkalosis
treat underlying cause
May ask to breath into bag if acute hyperventilation syndrome
Patient on ventilator with ph 7.55 pco2 28, what ph issue, you treat with
respiratory alkalosis
manage underlying cause
decrease vent rates
sedation may be necessary
The hallmark sign of low serum HCO3 suggests
Metabolic acidosis
Measurement of what gap lends to clues toward cause and treatments of metabolic acidosis; if increased this means
Anion Gap
=Na+K]-[hco3+cl)
Increased anion gap indicates acute incident
DKA, Alcoholic KA, lactic acidosis, drug or chemical anion would be examples of what type ph issue? what type of gap?
metabolic acidosis with increase anion gap
Diarrhea, Ileostomy, renal tubular acidosis, and recovery from DKA would be examples of what type ph issue? what type of gap?
metabolic acidosis with normal anion gap
Patient with history DMtype 1 comes in with 600 blood sugar, ph of 7.2 you suspect, and treat with, what type of
metabolic acidosis
treat underlying disorder and give fluid
Patient with hyperkalemia comes in with ph of 7.2 you suspect, and treat with, what type of gap would be seen
metabolic acidosis
would see normal GAP
treat with HCO3
Patient with history of chronic renal failure, comes in with sob, labs show ph 7.2, what type of ph issues is this,
meatbolic acidosis
bicitra
what ph issue is characterized by high plasma HCO3 and pco2 55mm
metabolic acidosis
what is the most common cause of metabolic alkalosis and how is it treated
volume contraction saline responsive,
Correct volume of deficit with na and Kcl
DC diurectics
H2 blockers (if GI loss)
Vomiting, diuretics, volume contraction, NG suction or post-hypercapnia would be seen in what ph issue
metabolic alcolosis
what is the most common cause of metabolic alkalosis and how is it treated if patient has severe CHF and vomiting
volume contraction
treat metabolic acidosis with acetazolamide if fluid resusitation is contraindicated
decrease diuretic
Hypokalemia with metabolic alkalosis should be treated how.
fluids and na and K+, discontinue diuretics
what is the most common cause of metabolic alkalosis and how is it treated if patient has severe CHF and vomiting
volume contraction
Acetazolamide 250-500 iv q4-6 if volume replacement is contradicted
Patient comes into clinic state vomiting for days, looks weak. During testing looks hyporeflexive. you suspect you treat how
Metabolic alkalosis with possible Hypokalemia
Treat with fluids replace K
