Acid Base Disorders Flashcards
With increase H+ what is the condition?
Acidosis
With decreased H+ what is the condition?
Alkalosis
What is the normal CO2 value?
35-45 mmHg
What is the normal Bicarb value?
22-26 mEq/L
What abnormalities exist in metabolism when a patient is acidotic?
Hyperkalemia
What abnormalities exist in metabolism when a patient is alkalotic?
- Decreased push of protons into the cell
- This means that the calcium, mag, K, are not getting pushed out of the cells so they can drop ECF
What abnormalities exist in the cardiovascular system when a patient is acidotic?
- Decreased cardiac output
- Vasodilation
- Increased ectopic rhythms from unstable cellular function
- Hyperkalemia
What abnormalities exist in the cardiovascular system when a patient is alkalotic?
- Leads to excitability
- Ventricular tachyarrhythmias
- SVT
- Hypokalemia
What abnormalities exist in the respiratory system when a patient is acidotic?
- Tachypnea
- Can drop CO2 to about 10 at lowest point
- Right shift
What abnormalities exist in the respiratory system when a patient is alkalotic?
- Low respiratory rate
- Left shift
What abnormalities exist in the CNS when a patient is acidotic?
- Decreases neurotransmitter release
- Decreased mental status
- Lethargic
What abnormalities exist in the CNS when a patient is alkalotic?
- Increase action potentials
- Seizures
- Tetany
What is the only intracellular buffer?
Hemoglobin
What does MUDPILES stand for?
Metabolic acidosis
M - Methanlol
U - Uremia
D - DKA
P - Paraldaehyde
I - INH/Iron
L - Lactic Acid
E - Ethylee glycol
S - Salicylates
What is a normal anion gap?
8-15
What is a wide anion gap?
> 15
Metabolic/Respiratory Acidosis/Alkalosis?
Patient is/has been vomiting?
Metabolic alkalosis
Metabolic/Respiratory Acidosis/Alkalosis?
Patient is a diabetic?
Metabolic acidosis
Metabolic/Respiratory Acidosis/Alkalosis?
Patient is a smoker/has COPD?
Respiratory acidosis
Metabolic/Respiratory Acidosis/Alkalosis?
Patient has a history of liver disease?
Respiratory alkalosis
Metabolic/Respiratory Acidosis/Alkalosis?
Patient with recent heavy ETOH use?
Metabolic acidosis
Metabolic/Respiratory Acidosis/Alkalosis?
Patient has/had diarrhea?
Metabolic acidosis
Metabolic/Respiratory Acidosis/Alkalosis?
Patient is tachypneic?
Respiratory alkolosis
Metabolic/Respiratory Acidosis/Alkalosis?
Patient is hypotensive?
Metabolic acidosis
Metabolic/Respiratory Acidosis/Alkalosis?
Patient is a post-respiratory/cardiac arrest?
Respiratory acidosis
What is the gold standard for evaluating acid-balance?
ABG
CO2 is the breakdown of what acid
Carbonic acid
CO2 is the result of what metabolite metabolism
carbs and fat
What is the treatment for respiratory acidosis?
Assist with ventilation
- Bronchodilators
- O2, Intubation
What is the treatment for respiratory alkolosis?
Typically no additional treatment beyond treatment of underlying problem - need to slow breathing (slow minute ventilation if ventilated)
What is the treatment for metabolic acidosis?
Insulin and volume resuscitation for DKA
+/- Sodium bicarb if severe (pH<7.1, HCO3<6)
