ACID-BASE BALANCE Flashcards
ACID BASE BALANCE
Process of regulating the pH, bicarbonate, and partial pressure of carbon dioxide of body fluids
ACID PRODUCTION
Generation of acid through cellular metabolism
ACID BUFFERING
Process to control changes in pH by neutralizing acid with buffers
ACID EXCRETION
Removal of acid from the body by the renal system(slowly) and by breathing quicker, faster, deeper
OPTIMAL LAB VALUES
pH- 7.35-7.45
CO2- 35-45
HCO3- 21-26
ACID BASE CONTROL ACTIONS : RESPIRATORY
Hyperventilation
Hypoventilation
Lungs compensate for acid-base imbalances of metabolic origin
ACID BASE CONTROL-KIDNEYS
3rd line of defense against pH changes Stronger regulating Takes longer than lungs Movement of bicarbonate Kidneys compensate when respiratory system is overwhelmed or unhealthy
COMPENSATION
Body’s attempt to correct pH
PH <6.9 or >7.8 is usually fatal
Respiratory system is more sensitive can begin compensating in seconds to minutes
Kidneys are more powerful fully triggered in several hours to days
BICARBONATE
Weak base
Major buffer of ECF (extracellular fluid)
Intestinal absorption into ECF, kidney absorption and breakdown of carbonic acid
* level is usually 20 times greater than carbonic acid
OPTIMAL ACID BASE BALANCE
Acid excretion keeps pace with acid production
Buffers are not overwhelmed
PH is maintained 7.35-7.45
RESPIRATORY ACIDOSIS
Chronic COPD (bronchitis)
End stage type A COPD (emphysema)
Not getting rid of CO2
DECREASED PAO2 WITH RISING PACO3
SIGNS AND SYMPTOMS OF RESPIRATORY ACIDOSIS
Bluish tint Patient cant catch breath Vasodilation hypotension Headache Short of breath K+ may rise Drowsy Difficulty getting air in and out
COPD
Air gets obstructed from getting all air out. Lung capacity expands to accommodate extra air. Emphysema( enlarged air spaces, barrel chest) Chronic bronchitis ( excessive mucous production, productive cough every winter)
NURSING RESPONSES TO IMPROVE OXYGENATION
Positioning
Pursed lip breathing
Relaxation techniques
Diaphragmatic breathing (belly breathing)]
NURSING RESPONSE FOR AIRWAY CLEARANCE
Stop smoking cessation Increase fluid intake Teach correct techniques for deep breathing and cough Physiotherapy and postural drainage Balance activity with rest
ACTIVITY TOLERANCE FOR COPD
Continue breathing exercises
Pace activities and monitor tolerance
Avoid temperature extreme temp changes
Pulmonary rehab classes
IMPROVE NUTRITIONAL INTAKE
High protein High calories Vitamin and nutritional supplements Rest before meals Small frequent meals
METABOLIC ACIDOSIS
Too much H+ (hydrogen)
Too little HCO3 (bicarbonate)
SIGNS AND SYMPTOMS METABOLIC ACIDOSIS
Hot and dry HYPERKALEMIA ( K+ leaves the cell, H+ goes in) Diabetic ketoacidosis renal failure Kaussmaul breathing Hyperventilation Dehydrated
CAUSES OF METABOLIC ACIDOSIS
1) overproduction of hydrogen ions
2) under elimination of hydrogen ions (kidney failure)
3) underproduction of bicarbonate
4) overelimination of bicarbonate ions (diarrhea)
TREATMENT OF METABOLIC ACIDOSIS
Rehydrate
Give insulin
Anti emetics
Anti diarrheal
ALKALOSIS
Loss of too much acid or retention of too much base
RESPIRATORY ALKALOSIS
Hyperventilation ( anxiety, fear, PE, mechanical respirations)
Dizzy, pale, confused
PH above 7.45
PCO2 under 35
METABOLIC ACIDOSIS
Increase of base or decrease of acids
Excessive intake of bicarbonate, carbonates, acetates, and citrates, use of too many antacids
Medical treatments such as massive blood transfusions and IV sodium bicarbonate given to correct acidosis