Acid Base Balance Flashcards
Major Chemicals affecting pH
- Bicarb, Hydrogen, CO2
- Lung chemicals → CO2 →acid
- Kidney chemicals → bicarbonate and hydrogen
Bbb bicarbonate is a base
H and CO2 are acids
normal pH
7.35 - 7.45
<7.35 = ACIDOSIS
>7.45 = ALKALOSIS
normal CO2
35 - 45
normal HCO3
22 -26
Acidotic person = ____
lethargic
Alkalotic person = ____
excitable (think seizures)
how does the body keep the pH within normal range?
compensation
Kidneys compensate by?
- Remove excess acid and bicarb by excreting them thru urine Or Kidneys can retain hydrogen and Bicarb and return to the blood
- Kidneys take hours to days to do their job– slow but efficient
Lungs compensate by?
- one way to get rid of CO2 → exhale!
- hyperventilation - ↓ CO2 → alkalosis
- hypoventilation - ↑ CO2 → acidosis
- Lungs respond FAST
normal PaO2
80 - 100
CO2 and O2 have an inverse relationship
↑ CO2 = ↓ O2
↑ CO2 = ↓ LOC!!!
Respiratory Acidosis pathophysio
• LUNG has a prob • CO2 cause of prob • ↑ CO2 • Hypoventilating • KIDNEYS compensate w/ bicarb and hydrogen = excrete hydrogen, retain bicarb • ↓ pH
Respiratory Acidosis Causes
Retain CO2:
Mid-abdominal incision, narcotics, sleeping pills, pneumothorax, collapsed lung, pneumonia, COPD
Respiratory Acidosis S/SX
- Headaches, confusion, sleepy
- if not treated = COMA (↑ CO2 = ↓ LOC!!!)
- HYPOXIC - give Oxygen!
early s/sx of hypoxia?
tachycardia and restlessness
Respiratory Acidosis Treatment
• fix the breathing problem
• PNEUMONIA: Liquefy and mobilize secretions w/
postural drainage
percussion (vibration therapy)
deep breathing exercises
suctioning
fluids
elevate HOB
incentive spirometry
• PENUMOTHORAX client will have CHEST tubes
• have post-op clients to TURN, COUGH, DEEP BREATHE
Restlessness, think ____ first
HYPOXIA
Respiratory Alkalosis pathophysio
• LUNG has a prob • CO2 cause of prob • ↓ CO2 • Hyperventilating = losing CO2 • KIDNEYS compensate w/ bicarb and hydrogen = excrete bicarb, retain hydrogen • ↑ pH
Respiratory Alkalosis Causes
• Hyperventilation
• Client breathing too FAST = removing CO2
- Hysterical (Situation) *prom sequin girl
- Acute aspirin OD
Respiratory Alkalosis S/SX
- lightheaded or faint feeling
- peri-oral numbness
- numbness and tingling in fingers and toes
Respiratory Alkalosis Treatment
• Breathe into a brown paper bag • Calm or sedate client to ↓ RR • Treat the cause - antidote for aspirin OD - sodium bicarbonate • Monitor ABGs
Metabolic Acidosis pathophysio
• KIDNEY has a prob • BICARB and HYDROGEN cause of prob • ↓ bicarb, ↑ hydrogen • LUNGS compensate w/ CO2 = RR will ↑ to get rid of acid • ↓ pH
Metabolic Acidosis Causes
DKA, Starvation
Renal failure
Severe diarrhea (Lower GI think base, losing base)
Metabolic Acidosis S/SX
• Depend on the cause
• Hyperkalemia - Muscle twitching, muscle weakness, flaccid paralysis, arrhythmias
• RR ↑
- Kussmaul respirations (↑ rate and depth) - blow off acid
• Potassium will go UP
Metabolic Acidosis Treatment
Treat the cause
Poop \_\_\_\_ (metabolic acidosis) Vomit \_\_\_\_ (metabolic alkalosis)
poop base, vomit acid
Metabolic Alkalosis pathophysio
- KIDNEY has a prob
- BICARB and HYDROGEN cause of prob
- ↑ bicarb, ↓ hydrogen
- LUNGS compensate w/ CO2
- ↑ pH
Metabolic Alkalosis Causes
- Loss of upper GI contents; Upper GI think acid, LOSING ACID
- Too many antacids…Too much BASE
Metabolic Alkalosis S/SX
- Depend on the cause
- Observe LOC
- Potassium will go DOWN
- Monitor for muscle cramps and life-threatening arrhythmias
Metabolic Alkalosis Treatment
Fix the problem
Replace Potassium
metabolic acidosis = ____
metabolic alkalosis = ____
Met. acidosis = HYPERKALEMIA
Met. alkalosis = HYPOKALEMIA
