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Marie- NUR 280 > Acid Base Imbalances > Flashcards

Acid Base Imbalances Flashcards

1
Q

normal blood pH

A

7.35-7.45

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2
Q

normal PCO2

A

35-45 mm Hg

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3
Q

normal PO2

A

90-100 mm Hg

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4
Q

normal HCO3-

A

22-26 mEq/L

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5
Q

normal SaO2

A

95-100%

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6
Q

What are the 3 major buffer systems?

A

phosphate, protein, and carbonic acid-bicarbonate buffering

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7
Q

phosphate buffer system

A
  • occurs in strictly ICF
  • regulates intracellular pH
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8
Q

protein buffer system

A
  • occurs inside and cell and bloodstream
  • albumin maintains acidity in and around cell
  • need healthy RBCs
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9
Q

carbonic acid-bicarbonate buffering

A
  • occurs only in bloodstream
  • how much acid is in blood vs how much bicarb
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10
Q

too much bicarb =

A

kidneys not working well and bicarb goes up

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11
Q

too much CO2 =

A

the body tries to get rid of it (compensation)

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12
Q

too little CO2 =

A

body tries to hold onto it

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13
Q

respiratory compensation

A
  • lungs compensate by adjusting ventilation to alter CO2 levels
  • ventilation, CO2 and pH are related
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14
Q

if pH is too acidic (acidosis) what will happen during compensation

A

ventilation will increase

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15
Q

if pH is too basic (alkalosis) what will happen during compensation

A

ventilation will decrease

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16
Q

renal compensation

A

adjust amount of HCO3- (bicarb) and H+ excreted and retained

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17
Q

if pH is too acidic what will happen during renal compensation

A
  • retain bicarb
  • excrete H+
18
Q

if pH is too basic what will happen during renal compensation

A
  • excrete bicarb
  • retain H+
19
Q

respiratory acidosis

A
  • pH less than 7.35
  • PCO2 greater than 45 mm Hg
  • hypoventilation
  • often due to pulmonary or airway obstruction
20
Q

how does respiratory acidosis present

A
  • anxiety
  • restlessness
  • headache
  • lethargy
  • fatigue
  • SOB
  • rapid breathing
  • cough
  • advanced respiratory acidosis may lead to confusion, possible coma
21
Q

compensation for respiratory acidosis

A

kidney reabsorb bicarb and excrete H+

22
Q

treatment for respiratory acidosis

A
  • improve ventilation
  • administer oxygen
23
Q

respiratory alkalosis

A
  • pH greater than 7.45
  • PCO2 less than 35 mmHg
  • hyperventilation
  • often due to anxiety
  • hypocalcemia nd hypokalemia may develop
24
Q

how does respiratory alkalosis present

A
  • tingling of extremities
  • tetany
  • dizziness
  • if patient is hypoxic, cyanosis may be present
25
Q

compensation for respiratory alkalosis

A

kidney reabsorb H+, excrete bicarb

26
Q

treatment for respiratory alkalosis

A
  • slow respiration
  • breathing into paper bag
27
Q

metabolic acidosis

A
  • pH less than 7.35
  • normal to low CO2
  • HCO3- less than 22mEq/L
  • hyperkalemia and hypercalcemia may develop
28
Q

causes of metabolic acidosis

A
  • excess acid: ex. diabetic ketoacidosis
  • bicarb loss: ex. GI disorders
29
Q

how does metabolic acidosis present

A
  • increased respirations
  • tachycardia
  • hypotension
  • confusion
30
Q

compensation for metabolic acidosis

A
  • lungs: increase ventilation
  • Kidneys: excrete H+, reabsorb HCO3-
31
Q

treatment for metabolic acidosis

A

correct underlying cause

32
Q

metabolic alkalosis

A
  • pH greater than 7.45
  • normal or high CO2
  • HCO3- greater than 26 mEq/L
  • hypocalcemia and hypokalemia may develop
33
Q

causes of metabolic alkalosis

A
  • excessive loss of acids, unrelated to CO2
  • kidneys and GI tract loss
  • increase in bicarb levels
34
Q

how does metabolic alkalosis present

A
  • confusion
  • dizziness
  • weakness
35
Q

compensation for metabolic alkalosis

A
  • lungs: decrease ventilation to increase CO2
  • kidneys: excrete HCO3- and retain H+
36
Q

treatment for metabolic alkalosis

A

electrolyte and fluid replacement

37
Q

how does acidosis affect pH and potassium

A

H+ shifts into cells and K+ shifts out of cells leading to hyperkalemia

38
Q

how does alkalosis affect pH and potassium

A

K+ ions shift into the cells from plasma leading to hypokalemia

39
Q

how does hyperkalemia affect pH and potassium

A

H+ shifts out of cells leading to acidosis

40
Q

how does hypokalemia affect pH and potassium

A

H+ shifts into cells leading to alkalosis

41
Q

how does acidosis affect pH and calcium

A
  • increased free Ca++ (fewer binding sites on albumin for Ca++ due to H+ binding
  • hypercalcemia

Marie- NUR 280 (12 decks)

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