acid-base disorders

Question 1

normal pH =

Answer 1

7.35-7.45

Question 2

normal PaO2 =

Answer 2

80-95 mmHg

Question 3

normal PaCO2 =

Answer 3

37-43 mmHg

Question 4

normal HCO3 =

Answer 4

22-26 mmol/L (22-26 mEq/L)

Question 5

Respiratory Alkalosis =

Answer 5

pH = 7.45
PaCO2 = 35 mmHg

Question 6

Respiratory Alkalosis

causes:

Answer 6

Anxiety sedatives
Chronic obstructive pulmonary disease (COPD)
Pain
Fever

CHF
CVA
PE meningitis Psychosis

Question 7

Respiratory Alkalosis

symptoms:

Answer 7

Dizziness
Paresthesia
Chest pain
Confusion
Seizure

Question 8

Respiratory Alkalosis

implications:

Answer 8

May need to coordinate treatments around ventilation.

Expect somnolence and fatigue

Question 9

Respiratory Acidosis =

Answer 9

pH = 7.35
PaCO2 = 45 mmHg

Question 10

Respiratory Acidosis

causes:

Answer 10

Decreasing ventilation

Depression of central respiratory center (drugs vs. cerebral disease)

Neuromuscular disease (ALS, GBS, MD)

Asthma/chronic obstructive pulmonary disease (COPD)

Question 11

Respiratory Acidosis

symptoms:

Answer 11

Confusion
Fatigue and/or lethargy
SOB
Somnolence

Question 12

Respiratory Acidosis

implications:

Answer 12

May need to coordinate treatments around ventilation.

Expect somnolence and fatigue

Question 13

Metabolic Alkalosis =

Answer 13

pH 7.45
HCO3 > 26 mmol/L

Question 14

Metabolic Alkalosis

causes:

Answer 14

Severe vomiting
Diarrhea
Severe dehydration
(diuretics)
Retention of bicarbonate

Decreasing ventilation
Causing increasing
Hypercapnia
Cystic fibrosis
Chloride-resistant

Question 15

Metabolic Alkalosis

symptoms:

Answer 15

CO2 retention

Question 16

Metabolic Alkalosis

clinical implications:

Answer 16

May need to coordinate treatments around ventilation

Expect somnolence and fatigue

Question 17

Metabolic Acidosis =

Answer 17

pH 7.35
HCO3 < 22 mmol/L

Question 18

Metabolic Acidosis

causes:

Answer 18

Increased acid production
Decreased renal acid
Excretion
Laxative abuse
Thiazide diuretics
Massive diuresis

Question 19

Metabolic Acidosis

symptoms:

Answer 19

Lactic acidosis
Ketoacidosis
Kidney disease
Cardiac arrhythmia w/ pH < 7.1
Diarrhea/other intestinal losses
Anxiety related to hypoxia

Question 20

Metabolic Acidosis

clinical implications:

Answer 20

May need to coordinate mobility around dialysis (CVVHD vs. HD)

Expect somnolence and fatigue

Consider risk of arrhythmias with mobility

Question 21

Anion Gap =

Answer 21

difference between free cations and free anions

major free cations are Sodium (Na+) and Potassium (K+)

major anions are Chloride (Cl-) and Bicarbonate (HCO3-)

Question 22

Anion Gap REFERENCE VALUE =

Answer 22

8 to 16 mEq without K+
12 to 20 mEq with K+

Question 23

Clinical Considerations – Elevated Anion Gap

Answer 23

ETOH Ketoacidosis