Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Electrolytes, Acid/base disturbances, endocrinology > Acid Base disturbances > Flashcards

Acid Base disturbances Flashcards

1
Q

what is the absolute base line for pH levels, especially when considering mixed disorders?

A

7.40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Respiratory Acidosis Labs

A

pH-decreased
CO2-increased
bicarb- increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the compensatory mechanism from the kidneys?

A

slow increase in plasma bicarb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what can cause RAci?

A

failure of lung to excrete CO2 from either alveolar hypoventilation leading to pulmonary CO2 retention or overproduction of CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the primary causes of RAc

A

any disorder that reduces pulmonary function and CO2 clearance- primary pulmonary dz, neuromuscular dz (myasthenia gravis) , primary CNS, parental nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical features of respiratory acidosis

A

metabolic encephalopathy- headaches and drowsiness

hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

lab findings for R ACid

A

ph decreased, PCO2 increased

2-5 days later plasma bicarb increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

tx for RAC

A

underlying disorder corrected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when to intubate pt in RAc?

A

when the PCO2 greater than 60 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ralk?

A

decreased blood PCO2 and increased blood pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PP of RAl?

A

excessive elimination of CO2 from increased ventalory drive

response- kidneys will gradually eliminate plasma bicarb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the most common cause of respiratory alk?

A

anxiety! (hysterical hyperventilation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

other causes of R Alk?

A

salicylate intoxication, hypoxia, intrathoracic disorders, primary CNS dysfxn , gram neg sepicemia, liver insuffic, PREGO? bad ventilator settings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CF of RAlk?

A

hyperventilation

breathing patter- frequent, deep, sighing respirations, to rapid deep breathing

acroparesthesias- burning of hands and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is acute alkalemia similar too?

A

hypocalemia- may produced a tetany-like syndrome

paresthesia of the extremities, chest discomfort, light-headedness, and confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lab findings of R. ALk?

A

PH increased, PCO2 decreased,

decreased in Plasma bicarb, serum chloride levels elevated- maintain electroneutrality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of RAL

A

light sedation- rebreathing techniques have fallen out of favor bc additional anxiety

18
Q

when is CO2 breathing mixtures of controlled ventilation requried?

A

when pH > 7.6

19
Q

Metabolic Acidosis?

A

elevation in H ion due to loss of bicarb or addition of H ions to serum

20
Q

what is the immediate response of metabolic acidosis?

A

increase in respiration

21
Q

what can cause an increase in Blood pH? and an increased anion gap?

A

lactic acidosis, DKA, starvation ketosis, ethylene glycol, methanol or salicylate intoxication

H ions may also be retained in renal tubular acidosis, renal insufficiency and adrenal insuficiency

22
Q

what are conditions that cause M Ac but with normal AG?

A

Diarrhea, pancreatic or biliary drainage, and uretral diversion

23
Q

CF of Met AC

A

hyperventilation- stimulation of respiratory drive to blow off CO2

  • ventricular arrhythmias
  • lethargy to frank coma
24
Q

what is winter’s formula?

A

PCO2= {1.5 X HCO3-] + 8 +/- 2

calculation of the expected PCO2 compensation

25
Q

Lab Studies for MAc

A

** bicarb follows the pH in metabolic disorders

make sure to calculate the AG

26
Q

What is hyperchloremic Metabolic acidosis?

A

Cl ion increased as bicarb decreased to maintain electroneutrality

(normal AG acidosis)

27
Q

common cuases of Normal AG renal tubular acidosis?

A

-either kidney failing to reabsorb bicarb or secrete acid

USED CARP

28
Q

what does USED CARP stand for?

A

Ureteroenterostomy
Small bowel fistual
Endocrinopathies/extra Cl
Diarrhea

Carbonic anhydrase inhibitors
Ammonium chloride
Renal tubular acidosis
Pancreatic Fistula

29
Q

What must be taken into considerations when calculating AG?

A

negative charge of albumin can impact overall AG

-hypoalbumiemia present: for each 1.0 g/dL decrease in serum albumin, the AD should be increasd by 2.5

30
Q

how is AG calculated?

A

Na - [HCO3- + Cl-]; normal is 8+/- 4

31
Q

what may cause elevated AG Acidosis?

A
  • lactic acidosis
  • ketoacidosis
  • toxins/drugs
  • kidney failure
32
Q

what does CAT MUD PILES stand for?

A 
Carbon Monoxide/Cyanide
Alcoholic ketoacidosis
Toluene
methanol
Uremia
DKA
Paraldehyde
Infection/Iron/Isoniazide
Lactic Acidosis
Ethylene glycol (antifreeze)
Salicylates (ASA)
33
Q

tx of MAc

A

remove primary cuase

Insulin therapy and volume repletion for DKA

34
Q

when do you use Bicarb tx for MAc?

A

when pH less than 7.20

35
Q

Metabolic Alkalosis?

A

increase in surm bicarb w/ no change in PCO2

pH > 7.42

36
Q

PP of m.alk?

A

kidney fails to excrete the excess bicarb

CO2 compensation= (0.7 X HCO3-) + 20 +/- 2

37
Q

what can cause M. Alk?

A

Vomiting, addition of bicarb (hyperalimentation therapy PPN) or Diarrhea (caused by loss of Cl)

-V
-NG tube suctioning
Villious adenoma
Chloride D
diuretics
hypercalcemia
milk-alki syndrome
mineralocorticoid excess
Bartter and Gitelman syndromes
Cl/K depletions of excessive steroids

38
Q

CF of Met Alk?

A

neuroligic abnormlaties
-low ionized Calcium: paresthesias, carpopedal spasm, light headedness

  • stupor, coma
  • sx from volume depletion: wksn, muscle cramps, postural dizzy
  • sx from K depletion: polyuria, polydipsia, weakness
39
Q

what does urine Chloride concentrations tell you in a met. alk pt?

A

hypovolemic hypochloremic patients w/ decreased urine Cl (< 20)

volume expanded pts- mineralocorticoid excess who have urine chloride concentrations > 30

40
Q

what are some interventions to help met. alk pts?

A

increase renal excretion of bicarb

depends on whether or not pt is chloride responsive

41
Q

what are some Chloride responsive condtions of Met. Alk? what is the tx?

A

gastric fluid loss, diuretic therapy

tx- NaCl

42
Q

Chloride resistant conditions and tx?

A

mineralcorticoid excess: removal of adrenal ademona

spironolactone- aldosterone antagonist

Electrolytes, Acid/base disturbances, endocrinology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions