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semester 2 2019 > acid/base balance and ABGs > Flashcards

acid/base balance and ABGs Flashcards

1
Q

what is an acidic solution?

A

one with a higher concentration of hydrogen ions than pure water

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2
Q

how is CO2 transported in the blood?

A

as carbonic acid/bicarbonate

bound to haemoglobin

dissolved in plasma

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3
Q

chemical symbol for carbonic acid?

A

H2CO3

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4
Q

what is the main way that carbon dioxide is carried in the blood?

A

converted to carbonic acid (can then disassociate to bicarbonate ion and H+ ion in the buffering system)

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5
Q

chemical symbol for hydrogen?

A

H+

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6
Q

chemical symbol for bicarbonate?

A

HCO3-

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7
Q

what ion concentration determines pH?

does more of this ion make the blood more acidic or more alkaline?

A

H+

more H+ = more acidic

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8
Q

what are the terms for more hydrogen/less hydrogen in the blood than usual

A

acidosis/alkalosis

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9
Q

what do acid/base imbalances generally result from?

A

respiratory or metabolic failures

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10
Q

what is respiratory acidosis?

what is its consequence?

A

a condition where CO2 accumulates in the blood because of respiratory impairment

blood becomes more acidic

hypoxaemic follows

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11
Q

common causes of respiratory acidosis?

A

impaired ventilation - ie opioid overdose

impaired gas exchange - eg. asthma, pneumonia

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12
Q

clinical signs of respiratory acidosis?

A

cyanosis
cold and clammy skin
issues around RR
disorientation

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13
Q

what is respiratory alkalosis?

A

Condition of high pH due to excessive ventilation, resulting in excess excretion of CO2 from the lungs → less H+ → more alkalotic

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14
Q

common causes of respiratory alkalosis?

A

hyperventilation ie panic attacks

fever - increases metabolic rate, increasing RR

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15
Q

what is metabolic acidosis?

A

Condition of low blood pH resulting from excess acid produced (H+), or loss of base (HCO3-)

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16
Q

common causes of metabolic acidosis?

A

DKA

chronic renal failure - excess loss of bicarbonate, extra H+ produces

diarrhoea - bicarbonate lost from GI tract

17
Q

clinical signs of metabolic acidosis?

A

kussmauls resps,

disorientation

18
Q

what is metabolic alkalosis?

A

Condition of high pH resulting from excessive retention of HCO3- or loss of H+

19
Q

common causes of metabolic alkalosis?

A

vomiting - H+ ions lost from system (stomach acid)

chronic kidney disease - increased secretion of H+ ions

20
Q

clinical signs of metabolic alkalosis?

A

slower breathing

confusion

21
Q

which two body systems regulate blood pH?

what is the other way the body regulates blood pH?

A

respiratory and metabolic (renal) systems

buffering system

22
Q

when discussing the regulation of blood pH, what is a buffer?

A

a chemical which acts as either an acid or base depending on the number of H+ ions present in the blood

23
Q

what are the four buffering pairs?

A
  1. Bicarbonate/carbonic acid system (HCO3-/H2CO3)
  2. Disodium/monosodium phosphate buffer system (HPO4-)
  3. Haemoglobin/oxyhaemoglobin system
  4. Protein buffer system
24
Q

what is any alteration to return to normal blood pH know as?

A

compensation

25
Q

what are the two types of compensation in regulation of blood pH?

A

complete compensation: pH returned to normal

partial compensation: signs of correction but pH has NOT returned to normal

26
Q

what does an arterial blood gases test (ABGs) measure?

A 
ph
PCO2
PO2
HCO3
SaO2 (represents amount of Hb sites which have attached O2)
27
Q

what regulates the amount of HCO3 in the blood?

A

the kidneys

28
Q

PaCO2 - normal range ABGs?

does a higher or lower value indicate acidosis?

respiratory or metabolic?

A

35-45 mmHg

higher indicates acidosis, lower indicates alkalosis

respiratory

29
Q

HCO3- :normal range ABGs?

does a higher or lower value indicate acidosis?

A

22-28 mEq/L

lower indicates acidosis, higher indicates alkalosis

30
Q

PaO2 - normal range ABGs?

what does a lower than normal value indicate?

A

80-100 mmHg

hypoxaemia

31
Q

six steps to ABG analysis

A
  1. Analyse the pH
  2. Analyse the PaCO2
  3. Analyse the HCO3
  4. Match the PaCO2 or the HCO3 with the pH
  5. Does the PaCO2 or the HCO3 go in the opposite direction of the pH? (IF YES, THEN THERE IS
    COMPENSATION BY THAT SYSTEM)
  6. Analyse the PaO2 and SaO2

semester 2 2019 (16 decks)

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