Acid-Base Disorders

Question 1

Normal human pH is ____

Answer 1

7.35 - 7.45

Question 2

Even small alterations in pH can result in ____ or _____ of proteins.

Answer 2

misconfiguration or denaturing

Question 3

the activities of almost all enzyme system throughout the body are influenced by the ____ concentration

Answer 3

H+

Question 4

Acid vs. a Base

Answer 4

Acid: Molecules that contain Hydrogen and can release H+ (HCl, H2CO3)
Base: Ion or molecule that can accept or bind free H+ (HCO3-, HPO4-)

Question 5

Acidosis vs. Alkalosis

Answer 5

Acidosis is excess addition of H+ to body fluids (pH under 7.35)
Alkalosis is excess removal of H+ from body fluids (pH over 7.45)

Question 6

To defend against changes in the concentration of hydrogen ions, the body uses three main defense mechanisms:

Answer 6

Buffering of Hydrogen Ions
Respiratory Regulation
Renal Regulation

Question 7

the body must continually dispose of ___ to keep the arterial pH within normal limits.

Answer 7

acid

Question 8

There are several buffering systems utilized in the body to manage the pH, the main one being the _____

Answer 8

Carbonic Acid - Bicarbonate System
H20 + Co2 <—> H2CO3 <—-> HCO3- + H+

Question 9

When looking at labs, think of CO2 as the ___

Answer 9

Respiratory Acid

Question 10

By adjusting how much HCO3- is reabsorbed and how much H+ is secreted, the ____ can manage the net loss of either acid or base.

Answer 10

kidneys

Question 11

When looking at labs, think of HCO3- as the ____

Answer 11

Metabolic Base

Question 12

By ____ back and forth on the Carbonic Acid System, the body maintains the pH

Answer 12

Compensating

Question 13

Acid-Base disorders include

Answer 13

Metabolic Acidosis
Metabolic Alkalosis
Respiratory Acidosis
Respiratory Alkalosis

Question 14

Metabolic Acidosis Results from_____ or_____

Answer 14

decreased HCO3-; increased Acid concentration

Question 15

Clinical causes of metabolic acidity

Answer 15

• Failure of the kidneys to excrete extracellular acids (due to renal diseases, whether acute or chronic)
• Formation of excess metabolic acids in the body (such as diabetic ketoacidosis, lactic acidosis, etc)
• Loss of base from body fluids (such as severe diarrhea, which results in loss of large amounts of bicarbonate in the feces)

Question 16

Metabolic Alkalosis Results from ____ or _____

Answer 16

increased HCO3- concentration; loss of excess H+.

Question 17

Clinical causes of metabolic alkalosis

Answer 17

• Increased ingestion of alkaline drugs, such as Sodium Bicarbonate.
• Excessive vomiting can result in loss of large amounts of acid from the gastric hydrochloric acid (HCl).
• Excessive Aldosterone secretion results in increased renal Na+ reabsorption, which also causes increased urinary excretion of H+.

Question 18

Respiratory Acidosis Results from ____ and ____

Answer 18

decreased ventilation; increased PCO2

Question 19

Clinical causes of Hypoventilation:

Answer 19

• Damage to respiratory center in the medulla oblongata
• Obstructive lung conditions, such as COPD, chest trauma, etc
• Factors that interfere with pulmonary gas exchange, such as pneumonia, pulmonary embolism, cardiac arrest, etc
• Other causes of hypoventilation, such as narcotic overdose

Question 20

Treatment for Respiratory Acidosis:

Answer 20

Treat underlying condition and hyperventilate.

Question 21

Respiratory Alkalosis Results from ___and ____

Answer 21

increased ventilation; decreased PCO2

Question 22

Clinical causes of Hyperventilation:

Answer 22

Anxiety, panic attacks, fever, some head injuries, COPD, asthma, pneumonia, pulmonary fibrosis, etc.

Question 23

An acute metabolic complication of diabetes characterized by

Answer 23

• Hyperglycemia, hyperketonemia, and metabolic acidosis
• DKA occurs mostly in individuals with Type 1 DM

Question 24

What is Ketogenesis?

Answer 24

Glucagon stimulates mitochondrial conversion of free fatty acids into ketones, mostly in the liver

Question 25

ketone bodies are oxidized by several enzymes in the cells to produce ____, which can then be used for cellular energy

Answer 25

ATP

Question 26

Breakdown of ketones is called ____

Answer 26

ketolysis

Question 27

DKA is an important form of ____

Answer 27

metabolic acidosis

Question 28

T/F Ketones are Acids

Answer 28

T

Question 29

In situations when tissues are being deprived of oxygen (such as shock, sepsis, heart failure, COPD, etc.), ____ Respiration may be needed.

Answer 29

Anaerobic

Question 30

During Anaerobic Respiration, ____ can still occur

Answer 30

glycolysis
However, in order to keep glycolysis going, enzymatic processes need to occur in the absence of oxygen.

Question 31

Anaerobic Respiration produces _____

Answer 31

Lactate (lactic acid)

Question 32

____ is a diagnostic assessment that can be used to evaluate a patient’s Acid-Base status, and diagnose Hypoxia

Answer 32

ABG = Arterial Blood Gas

Question 33

An ABG provides the clinician with

Answer 33

Arterial pH
Arterial PCO2
Arterial PO2
Percentage of O2 Saturation
Bicarbonate (HCO3-)

Question 34

ABG collection is not significantly invasive but does have a few potential complications including:

Answer 34

Arterial thrombosis or occlusion, and Bleeding

Question 35

The ____ is almost always the artery sampled for an ABG

Answer 35

Radial Artery

Question 36

6 steps to ABG interpretation

Answer 36

1. pH - is there acidosis or alkalosis?
2. Is the CO2 normal?
3. Is the HCO3 normal?
4. Match the CO2 or the HCO3 with the pH.
5. Does CO2 or HCO3 go the opposite direction of the pH?
6. Are the PO2 and O2 Saturation normal?

Question 37

Assessing if the CO2 is normal

Answer 37

35-45 is normal
Greater than 45 is considered Acidic.
Less than 35 is considered Alkalotic.

Question 38

Assessing the HCO3

Answer 38

Normal range is 22-26
Greater than 26 is considered Alkalotic.
Less than 22 is considered Acidic.

Question 39

Assessing if PO2 and O2 saturation are normal

Answer 39

Normal PO2 is 80-100 mmHg, O2 sat is 95-100%
A PO2 of 60 mmHg generally correlates with an O2 Saturation of about 90%.
If PO2 or O2Sat are low, your patient is Hypoxic and should be placed on O2.