Acid-base balance and blood gases

Question 1

What has Immediate Buffering capacity and what has major blood buffering capacity? 

Answer 1

Immediate- HCO3
Major- Hemoglobin

Question 2

Has small contribution to buffering but is important in urine? 

Answer 2

Phosphorus 

Question 3

What is the normal pH Of blood?

Answer 3

7.35-7.45

Question 4

I’m body, pK is…

Answer 4

6.11

Question 5

By carbonate cannot be accurately measured but can be calculated from…

Answer 5

TCO2 and PCO2 values can be measured

Question 6

What are the two forms of metabolic acidosis?

Answer 6

• increased organic acids that lead to decreased bicarbonate
• decreased by carbonate due to diarrhea

-Both of which is less than 20

Question 7

What are causes of metabolic acidosis?

Answer 7

-uncontrolled diabetes mellitus
-Fasting or fad diet
-Strenuous exercise
-Hypoxia
-Renal tubular acidosis
-Liver disease
-In gestation of Salicylic acid or other poisons

Question 8

How is metabolic acidosis compensated for initially? long term?

Answer 8

Hyper ventilating (Respiratory compensation)

Kidneys will excrete organic acids and exchange H+ for Na+ (metabolic compensation)***

Question 9

What are the laboratory findings for metabolic acidosis?

Answer 9

Increased lactic acid, anion gap, potassium*

Decreased pH, HCO3, O2 saturation, pCO2*

[pCO2 goes down and potassium goes up]*


Question 10

In respiratory acidosis and metabolic acidosis ([HCO3-]/ apCO2) < ____

Answer 10

20

Question 11

What are possible causes of respiratory acidosis?

Answer 11

Pulmonary edema, bronchial constriction, pneumonia, asthma, emphysema, apnea, bradycardia, respiratory depression, respiratory distress syndrome

Question 12

How does a body compensate for respiratory acidosis?

Answer 12

Metabolic alkalosis by retaining sodium and bicarbonate and hyper ventilating, development of normal pH but with excessive bicarbonate

Question 13

What is the laboratory findings for respiratory acidosis?

Answer 13

Increased pCO2, with renal compensation (Increased bicarbonate)

Question 14

Treatment for metabolic acidosis and respiratory acidosis…

Answer 14

Metabolic acidosis: Insulin, can add bicarbonate

Respiratory acidosis: Initial treatment may also require Na-HCO3-

Question 15

For metabolic alkalosis [HCO3-]/apCO2 > 20; _________ HCO3

Answer 15

Increased

(Decreased for respiratory alkalosis)

Question 16

What are causes for respiratory alkalosis? 

Answer 16

hyperventilation (Excessive crying, CNS control of respiration, asthma, fever, pulmonary embolism) 

Question 17

Causes of metabolic alkalosis..

Answer 17

Hyperaldosteronism (Cushing’s syndrome) May cause hypokalemia (Increased HCO3) In plasma as potassium moves from inside to outside the cell with hydrogen moving in)

Question 18

How does the body compensate for metabolic alkalosis?

Answer 18

By slowing respiratory system thus increasing pCO2

Question 19

Long-term how will the body respond to metabolic alkalosis?

Answer 19

Can you excrete excessive by carbonate if underlying evening cause is corrected

Question 20

What are the laboratory findings of metabolic alkalosis?

Answer 20

Ratio (HCO3-/apCO2) is increase but so does pCO2 (Compensation) Your own will contain titratable bicarbonate

Question 21

What is the treatment for metabolic alkalosis?

Answer 21

Administer sodium chloride or potassium chloride, Ammonia chloride if alkalosis is severe (hydrogens can be used) 

Question 22

What is the response to respiratory alkalosis?

Answer 22

Can you will secrete excessive bicarbonate

Question 23

What are the laboratory findings for respiratory alkalosis?

Answer 23

Hyperventilation leads to decreased pCO2 (a Cause of respiratory alkalosis) Increased amounts of bicarbonate in urine

Question 24

What is the treatment for respiratory alkalosis?

Answer 24

Sedatives, have pt breath in paper bag