Acid Base Imbalance

Question 1

Normal PH

Answer 1

7.35 - 7.45

Question 2

Normal HCO3

Answer 2

22-26

Question 3

Normal Paco2

Answer 3

35-45

Question 4

What are the 3 buffer systems

Answer 4

1. Chemical buffer
2. Respiratory compensation
3. Renal compensation

Question 5

low concentration of H+ ions

Answer 5

low pH = acidosis

Question 6

high concentration of H+ ions

Answer 6

high pH = alkalosis

Question 7

what are the 4 chemical buffer systems?

Answer 7

1. bicarbonate buffers
   - primary extracellular, bind to and release H+ ions
2. phosphate and ammonium buffers
   - kidneys
3. both intracellular (hemoglobin) and extracellular (albumin and globulins)
4. Potassium - hydrogen exchange
   - H+ and K+ move freely
   - H+ moves in K+ moves out of cell

Question 8

Respiratory compensation

Answer 8

• retaining or blowing Co2
• pH is returned to normal by the system that is not primarily affected

Question 9

Renal compensation

Answer 9

slower
- retention/excretion of bicarbonate by kidneys
- elimination of H+ in urine
- production of new bicarbonate

Question 10

Acidosis physiological effect

Answer 10

• decreases cardiac contractility
• interferes with action of drugs
• Nervous system changes

Question 11

How to tell if someone is in Respiratory acidosis

Answer 11

increased CO2 and decreased pH INVERSED

Question 12

What is repiratory acidosis caused by?

Answer 12

directly related to the rate and depth of breathing
CAUSED BY
- disorders of ventilation
- increased co2 production

Question 13

How to tell if someone is in Metabolic acidosis?

Answer 13

deficit of bicarbonate and decreased pH (SAME)

Question 14

What is metabolic acidosis caused by?

Answer 14

• Increased production of metabolic acids
• decreased renal function
• increased bicarbonate loss
• hyperchloremic acidosis

Question 15

Alkalosis

Answer 15

ph>7.45 due to acid deficit or base excess

Question 16

What does Excess Bicarb do?

Answer 16

• 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

Question 17

How do you tell if someone is in repiratory alkalosis?

Answer 17

decreased pco2 and increased pH (INVERSE)

Question 18

what is respiratory alkalosis caused by?

Answer 18

• hyperventilation
• mechanical ventilation if settings are to high
• central stimulation of respiratory center = anxiety, pain, stress, fever, certain medications

Question 19

Clinical manifestations of Respiratory alkalosis?

Answer 19

light headed, dizzy, construction of BV, numbness, tingling of toes and fingers

Question 20

clinical manifestations of metabolic acidosis?

Answer 20

low bp, abdominal pain, vomiting, headaches, weakness, fatigue

Question 21

clinical manifestations of Respiratory Acidosis?

Answer 21

drug overdose, airway obstruction, sepsis, burns, fevers, exercise, headaches, impaired consciousness, CO2 poisoning

Question 22

How do you tell if someone is in metabolic alkalosis?

Answer 22

their ph is high and HCO3 is high

Question 23

What is metabolic acidosis caused by?

Answer 23

• excess alkali intake = Ivs
• bicarbonate retention (RARE if kidneys are functioning)
• gastrointestinal losses = vomiting

Question 24

what are some clinical manifestatons of metabolic alkalosis?

Answer 24

light headed, dizzy, construction of BV, numbness, tingling of toes and fingers (SAME as respiratory)