Acid Base Balance

Question 1

Major Chemicals affecting pH

Answer 1

• Bicarb, Hydrogen, CO2
• Lung chemicals → CO2 →acid
• Kidney chemicals → bicarbonate and hydrogen

Bbb bicarbonate is a base
H and CO2 are acids

Question 2

normal pH

Answer 2

7.35 - 7.45
<7.35 = ACIDOSIS
>7.45 = ALKALOSIS

Question 3

normal CO2

Answer 3

35 - 45

Question 4

normal HCO3

Answer 4

22 -26

Question 5

Acidotic person = ____

Answer 5

lethargic

Question 6

Alkalotic person = ____

Answer 6

excitable (think seizures)

Question 7

how does the body keep the pH within normal range?

Answer 7

compensation

Question 8

Kidneys compensate by?

Answer 8

• 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

Question 9

Lungs compensate by?

Answer 9

• one way to get rid of CO2 → exhale!
• hyperventilation - ↓ CO2 → alkalosis
• hypoventilation - ↑ CO2 → acidosis
• Lungs respond FAST

Question 10

normal PaO2

Answer 10

80 - 100

Question 11

CO2 and O2 have an inverse relationship

↑ CO2 = ↓ O2

Answer 11

↑ CO2 = ↓ LOC!!!

Question 12

Respiratory Acidosis pathophysio

Answer 12

• LUNG has a prob
• CO2 cause of prob
• ↑ CO2
• Hypoventilating
• KIDNEYS compensate w/ bicarb and hydrogen
= excrete hydrogen, retain bicarb
• ↓ pH

Question 13

Respiratory Acidosis Causes

Answer 13

Retain CO2:

Mid-abdominal incision, narcotics, sleeping pills, pneumothorax, collapsed lung, pneumonia, COPD

Question 14

Respiratory Acidosis S/SX

Answer 14

• Headaches, confusion, sleepy
• if not treated = COMA (↑ CO2 = ↓ LOC!!!)
• HYPOXIC - give Oxygen!

Question 15

early s/sx of hypoxia?

Answer 15

tachycardia and restlessness

Question 16

Respiratory Acidosis Treatment

Answer 16

• 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

Question 17

Restlessness, think ____ first

Answer 17

HYPOXIA

Question 18

Respiratory Alkalosis pathophysio

Answer 18

• LUNG has a prob
• CO2 cause of prob
• ↓ CO2
• Hyperventilating = losing CO2
• KIDNEYS compensate w/ bicarb and hydrogen
= excrete bicarb, retain hydrogen
• ↑ pH

Question 19

Respiratory Alkalosis Causes

Answer 19

• Hyperventilation
• Client breathing too FAST = removing CO2
- Hysterical (Situation) *prom sequin girl
- Acute aspirin OD

Question 20

Respiratory Alkalosis S/SX

Answer 20

• lightheaded or faint feeling
• peri-oral numbness
• numbness and tingling in fingers and toes

Question 21

Respiratory Alkalosis Treatment

Answer 21

• Breathe into a brown paper bag
• Calm or sedate client to ↓ RR
• Treat the cause
- antidote for aspirin OD - sodium bicarbonate
• Monitor ABGs

Question 22

Metabolic Acidosis pathophysio

Answer 22

• KIDNEY has a prob
• BICARB and HYDROGEN cause of prob
• ↓ bicarb, ↑ hydrogen
• LUNGS compensate w/ CO2
= RR will ↑ to get rid of acid
• ↓ pH

Question 23

Metabolic Acidosis Causes

Answer 23

DKA, Starvation
Renal failure
Severe diarrhea (Lower GI think base, losing base)

Question 24

Metabolic Acidosis S/SX

Answer 24

• 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

Question 25

Metabolic Acidosis Treatment

Answer 25

Treat the cause

Question 26

Poop \_\_\_\_ (metabolic acidosis)
Vomit \_\_\_\_ (metabolic alkalosis)

Answer 26

poop base, vomit acid

Question 27

Metabolic Alkalosis pathophysio

Answer 27

• KIDNEY has a prob
• BICARB and HYDROGEN cause of prob
• ↑ bicarb, ↓ hydrogen
• LUNGS compensate w/ CO2
• ↑ pH

Question 28

Metabolic Alkalosis Causes

Answer 28

• Loss of upper GI contents; Upper GI think acid, LOSING ACID
• Too many antacids…Too much BASE

Question 29

Metabolic Alkalosis S/SX

Answer 29

• Depend on the cause
• Observe LOC
• Potassium will go DOWN
• Monitor for muscle cramps and life-threatening arrhythmias

Question 30

Metabolic Alkalosis Treatment

Answer 30

Fix the problem

Replace Potassium

Question 31

metabolic acidosis = ____

metabolic alkalosis = ____

Answer 31

Met. acidosis = HYPERKALEMIA

Met. alkalosis = HYPOKALEMIA