Acid Base Clinical

Question 1

what is adaptive response for metabolic acidosis?

Answer 1

hyperventilation

Question 2

what is the adaptive response for metabolic akalosis?

Answer 2

hypoventilation

Question 3

what is the adaptive response for respiratory acidosis?

Answer 3

secretion of H+ and retention of HCO3

Question 4

what is the adaptive response for respiratory alkalosis?

Answer 4

retaining H+ and less HCO3 reabsorption

Question 5

name the four steps in reading blood gases

Answer 5

determine if acidemia/alkalemia
determine if respiratory or metabolic
determine if compensated or not
determine anion gap

Question 6

in metabolic acidosis will CO2 be elevated lowered or unchanged?

Answer 6

either lower or unchanged

Question 7

in respiratory acidosis will CO2 be elevated lowered or unchanged?

Answer 7

elevated

Question 8

what acid base imbalance is the winters equation useful for?

Answer 8

metabolic acidosis

Question 9

what is the winters equation?

Answer 9

PaCO2=(1.5xHCO3) + (8)

Question 10

what is the equation for metabolic alkalosis compensation?

Answer 10

increase in HCO3 by 1 means 0.7 increase in PaCO2 expected

Question 11

what is the equation for respiratory acidosis acute and chronic compensation?

Answer 11

for every 10 increase in CO2…1 increase in HCO3

for every 10 increase in CO2…3.5 increase in HCO3

Question 12

what is the equation for respiratory alkalosis acute and chronic compensation?

Answer 12

for every 10 decrease in CO2…2 decrease in HCO3

for every 10 decrease in CO2…4 decrease in HCO3

Question 13

what is mnemonic for anion gaps?

Answer 13

MUDPILES

Question 14

what is the mnemonic for non anion gaps?

Answer 14

HARD UP

Question 15

does diabetic acidosis lead to anion gap or non anion gap?

Answer 15

anion gap

Question 16

does diarrhea lead to anion gap or non anion gap?

Answer 16

non anion gap

Question 17

does lactic acidosis leas to anion gap or non anion gap?

Answer 17

anion gap

Question 18

does hyperchloremia lead to anion gap or non anion gap?

Answer 18

non anion gap

Question 19

what acid base imbalance does vomiting lead to?

Answer 19

metabolic alkalosis

Question 20

name three conditions that indicate a time to use mechanical ventilation

Answer 20

hypoxemic respiratory failure
hypercarbic respiratory failure
unstable airway

Question 21

what is PEEP? what is it useful for in mechanical ventilation?

Answer 21

positive end expiratory pressure…good for preventing alveolar collapse

Question 22

what are the two overarching modes of mechanical ventilation that you can choose from?

Answer 22

either volume setting so setting volume of tidal breath

or

pressure setting so setting amount of pressure given with each breath

Question 23

what are the two modes of expiration that you can have in mechanical ventilation?

Answer 23

mandatory…mandatory number of breaths from ventilator per minute

non mandatory…no mandatory number of breaths from the ventilator, all up to patient

Question 24

if a patient is hypercarbic on the ventilator…what should you adjust?

Answer 24

increase tidal volume or respiratory rate

Question 25

if a patient is hypoxemic on ventilator, what should you adjust?

Answer 25

FiO2 or PEEP