Acid-Base Disorders Flashcards
Number 1 negative Inotrop
Acidosis
how are lab values written?
pH/CO2/O2/HCO3-/BE
Hypocapnia?
low CO2
Hypercapnia?
High CO2
Primary ____ changes bring secondary _____ changes.
CO2, HCO3-
HCO3-, CO2
decreased blood pH and HCO3- plasma concentration
-Compensation: decreased CO2 concentration (respiratory response)
Metabolic acidosis
Lactate acidosis:
increase in plasma l-lactate
Ketoacidosis:
Increased FA production and accumulating ketoacids
Alcoholic Ketoacidosis:
poor nutritional status in the setting of abrupt alcohol cessation and or binge drinking
ways acid accumulates:
- Ingestion: Methanol, ethylene glycol, alcohol, salicylates
- Renal failure
Renal failure:
worsening renal function and fewer nephrons lead to worsening filtration of anions & reduced HCO3⁻ production.
2 ways metabolic acidosis happens:
acid build up and bicarbonate loss
Bicarbonate loss:
- Diarrhea
- Proximal renal tubular acidosis: impaired reabsorption leads to urinary wasting
increased arterial pH and plasma HCO3-
-Compensation: increased PaCO2
Metabolic alkalosis
What causes metabolic alkalosis:
- net gain of HCO3- in or net loss of acids from ECF
- often accompanied w/ hypochloremia and hypokalemia
- patients hypoventilate
Alkali administration:
HCO3⁻ admin., acetate admin. (HAL), citrate admin. (blood transfusion)
Gi metabolic alkalosis:
vomiting and NG aspiration leads to H+ loss
Renal metabolic acidosis:
ECF contraction leads to effective HCO3⁻ gain (contraction alkalosis) Diuretic administration (loop diuretics) common.
decreased blood pH and increased CO2
-Compensation: increase in buffering HCO3-
Respiratory acidosis
S/s:
Acute: confusion, dyspnea, anxiety
Chronic: daytime somnolence, memory loss, motor disturbances
Hypercapnia, seen with respiratory acidosis.
