Acid base disorders Flashcards
Buffer equation
CO2 + H2O <-> H2CO3 <-> H+ + HCO3-
Carbonic buffer system
fastest adjustment of blood pH, happens in seconds by buffering changes
Lungs buffer system
Decrease in RR Increases pCO2 which reduces pH
Increase in RR decreases pCO2 which increases pH
Arterial blood gas test
taking blood from an artery increase accuracy of gas measurement.
Primary respiratory alkalosis
pH >7.4 with low pCO2 (increased RR)
caused by nicotine, anxiety or high altitude hyperventilation
Alkalosis Sx
Mild CNS, dizziness, tingling in extremities, weakness. Severe goes to confusion and seizure, hypokalemia
Acidosis Sx
Headache, delirium, coma, tachycardia, arrhythmia, hyperkalemia, insulin resistance
Primary metabolic alkalosis
pH >7.4 high HCO3-
caused by intake of bicarbonate, renal failure (retention), H+ loss (vomiting, diarrhea
Primary metabolic acidosis
pH <7.4 low HCO3-
Calculate anion gap to find cause
AG test
unmeasured anions (proteins, calcium) - unmeasured cations (albumin, ketones, lactate)
AG = 12
Acidosis not caused by unmeasured ions. Check for bicarbonate loss (diarrhea, drugs (acetazolamide, amphotericin B), fluid, renal failure
HARDUP
causes of non AG metabolic acidosis
Hyperalimentation
acetazolamine
renal tubular acidosis
diarrhea/dilution
ureteral diversion
pancreatic fistula
AG <8
Lack of anions (uncommon)
likely hypoalbuminemia
AG >14
excess anions Ketoacidosis, lactic acidosis, ethanol, metformin, propofol, iron, salicylates, renal failure
MUDPILES
causes of anion diefincy acidosis
Metformin/methanol
uremia
diabetic ketoacidosis
propofol
iron
lactate
ethylene glycol
salicylates/starvation
