Acid Base Imbalance Flashcards
Normal PH
7.35 - 7.45
Normal HCO3
22-26
Normal Paco2
35-45
What are the 3 buffer systems
- Chemical buffer
- Respiratory compensation
- Renal compensation
low concentration of H+ ions
low pH = acidosis
high concentration of H+ ions
high pH = alkalosis
what are the 4 chemical buffer systems?
- bicarbonate buffers
- primary extracellular, bind to and release H+ ions - phosphate and ammonium buffers
- kidneys - both intracellular (hemoglobin) and extracellular (albumin and globulins)
- Potassium - hydrogen exchange
- H+ and K+ move freely
- H+ moves in K+ moves out of cell
Respiratory compensation
- retaining or blowing Co2
- pH is returned to normal by the system that is not primarily affected
Renal compensation
slower
- retention/excretion of bicarbonate by kidneys
- elimination of H+ in urine
- production of new bicarbonate
Acidosis physiological effect
- decreases cardiac contractility
- interferes with action of drugs
- Nervous system changes
How to tell if someone is in Respiratory acidosis
increased CO2 and decreased pH INVERSED
What is repiratory acidosis caused by?
directly related to the rate and depth of breathing
CAUSED BY
- disorders of ventilation
- increased co2 production
How to tell if someone is in Metabolic acidosis?
deficit of bicarbonate and decreased pH (SAME)
What is metabolic acidosis caused by?
- Increased production of metabolic acids
- decreased renal function
- increased bicarbonate loss
- hyperchloremic acidosis
Alkalosis
ph>7.45 due to acid deficit or base excess
What does Excess Bicarb do?
- produced from the breakdown of carbonic acid, Gi intake of ingested bicarbonate, renal reabsorption of bicarbonate
- inhibits o2 release from RBC = hypoxia
- effects the rythem of cardiac system
- effects the nervous system
How do you tell if someone is in repiratory alkalosis?
decreased pco2 and increased pH (INVERSE)
what is respiratory alkalosis caused by?
- hyperventilation
- mechanical ventilation if settings are to high
- central stimulation of respiratory center = anxiety, pain, stress, fever, certain medications
Clinical manifestations of Respiratory alkalosis?
light headed, dizzy, construction of BV, numbness, tingling of toes and fingers
clinical manifestations of metabolic acidosis?
low bp, abdominal pain, vomiting, headaches, weakness, fatigue
clinical manifestations of Respiratory Acidosis?
drug overdose, airway obstruction, sepsis, burns, fevers, exercise, headaches, impaired consciousness, CO2 poisoning
How do you tell if someone is in metabolic alkalosis?
their ph is high and HCO3 is high
What is metabolic acidosis caused by?
- excess alkali intake = Ivs
- bicarbonate retention (RARE if kidneys are functioning)
- gastrointestinal losses = vomiting
what are some clinical manifestatons of metabolic alkalosis?
light headed, dizzy, construction of BV, numbness, tingling of toes and fingers (SAME as respiratory)
