Acid/Base Disorders Flashcards
Metabolic disorder
disorder caused primarily through alterations in bicarbonate
Respiratory disorder
disorder caused primarily through alterations in carbon dioxide
What are the responsible parties in metabolic disorders; respiratory
kidneys; lungs
hyperventilation causes what change in pH
increase/ alkalosis: more loss of carbon dioxide (the acid portion)
What is the acid compound; base compound
PaCO2; HCO3
In respiratory compensation how does it occur, how many phases are there and how quickly is it
changes in breathing, one phase, minutes to hours
In metabolic compensation how many phases, what are they, are there, how long are the phases
two phases: acute and chronic, 24 hours and 72 hours. There can be a period where this no compensation before 24 hours.
What are the three most important aterial blood gas components and serum chemistry panel, what are the normal values
pH,PaCO2,HCO3; 7.4, 40, 24
High PaCO2 causes
Respiratory acidosis
Low PaCO2 causes
Respiratory alkalosis
High HCO3 causes
Metabolic alkalosis
Low HCO3 causes
Metabolic acidosis
Causes of metabolic acidosis
Excess acid production, loss of bicarbonate base,diminished renal acid secretion,renal loss of bicarbonate base
What causes excess acid production Hint(Mudpiles) also known as high anion gap metabolic acidosis
Methanol, uremia, diabetic ketoacidosis, paraldehyde/propylene glycol, isoniazid, lactic acidosis, ethylene glycol, salicylates
What does winter’s formula give
What the PaCO2 value should be if there is compensation present
If winter’s formula is used and the measured PCO2 is higher than the predicted value what does this mean
Concurrent respiratory acidosis
If Winter’s formula is used the measured PCO2 is lower than the predicated value what does this mean
Concurrent respiratory alkalosis
Causes of respiratory acidosis
The patient cannot breathe or will not breathe, increased dead space (alveolar deadspace)
In acute metabolic compensation for respiratory acidosis what should be the predicted values
for every increase by 10 of PCO2 there should be +1 HCO3
In chronic metabolic compensation for respiratory acidosis what should be the predicted values
for every increase by 10 of PCO2 there should be +3 HCO3
If the measured HCO3 is lower than predicted in metabolic compensation what does this mean
There is concurrent metabolic acidosis OR no compensation
If the measured HCO3 is higher than predicted in metabolic compensation what does this mean
There is concurrent metabolic alkalosis
What causes Metabolic alkalois
Hydrogen ion loss, Excessive retention of HCO3, loss of volume contraction around a relatively stable amount of HCO3
In respiratory compensation for metabolic alkalosis what does it mean if the PaCO2 is less than predicted, more than predicted
concurrent respiratory alkalosis, concurrent respiratory acidosis
What cause respiratory alkalosis
anxiety, pain, high altitudes, intoxications
In the acute phase for metabolic compensation of respiratory alkalosis what should the value be
For every decrease by 10 of PaCO2 there should be a decrease of HCO3 by -2
In the chronic phase for metabolic compensation of respiratory alkalosis what should the value be
For every decrease by 10 of PaCO2 there should be a decrease of HCO3 by -4
In metabolic compensation for respiratory alkalosis what does it mean if the measured value HCO3 is less than expected
concurrent metabolic acidosis
in metabolic compensation for respiratory alkalosis what does it mean if the measured value HCO3 is more than expected
concurrent metabolic alkalosis OR not yet compensated
What is the 5 step approach to figuring out acid-base disorders
1) Check the contributors
2) Check to see the type of emia
3) Check to see if the blame is respiratory
4) See if there is a metabolic component
5) Check to see if there is compensation
Delta Ratio meanings
If the Delta ratio= 1 the change in anion gap is due to HCO3, if the delta ratio is greater than 1.6 there is concurrent metabolic alkalosis. if the delta ratio is less than .8 there is concurrent non-anion gap metabolic acidosis
