Acid Base Imbalances Flashcards
whats the normal pH level
7.35-7.45
whats the normal bicarb lvl
22-26
what are the steps to interpreting blood gasses:
1) look at pH and bicard lvls
2) determine if each lvl is high, low, or normal
what does a pH above 7.45 mean
- alkalosis
what does a pH below 7.35 mean
- acidosis
if both the pH and bicard are in the same direction ( both high or both low), what does that mean?
- metabolic
(think: bicarb both bolic)
if the pH and bicarb are in different directions (one is high while the other is low), what does that mean?
- respiratory
ex. the pH and bicard are low. What is this?
- metabolic acidosis
ex. the pH and bicard are both high. what is this?
- metabolic alkalosis
ex. the pH is low, and the bicarb is high. What is this?
- respiratory acidosis
ex. the pH is 7.5 and bicard is 25. what is this?
- respiratory alkalosis
what is the general principle for the symptoms of a high pH?
- as the pH goes up, so does my patient
what are examples of symptoms of a high pH
- irritability
- hyperreflexia (+3, +4)
- tachypnea
- tachycardia
- borborygmi (increased bowel sounds)
- seizures (have suction at bedside)
what is the general principle for signs of a low pH
- as the pH goes down, so does my patient
what are examples of signs of a low pH
- hyporeflexia (0-1)
- bradycardia
- lethargy, obtundant, coma
- paralytic/adynamic ileus
- resp arrest (have ampu bag at bedside)
- 2* mobitx type 2 heart block
when my pH goes up, so does my patient EXCEPT…
K+ (and vice versa). K+ goes down
what is kussmaul breathing
deep, rapid, and labored breathing
kussmaul breathing is only seen with…
- metabolic acidosis
(think: mac kussmaul)
what is the general principle for the causes of acid-base imbalances
- often, what causes something is the opposite of its symptoms
ex. diarrhea causes metabolic acidosis, but once the pt gets acidosis, they get paralytic ileus as a symptoms
what are the steps to determining what type of acid-base imbalance a patient is in when given a scenario (no lab values)
1) ask: is it a lung scenario ? (if so, resp)
2) is the pt over or under ventilating (not RR, r/t gas exchange & SpO2)
if a pt is over ventilating, what does it mean? under?
- over ventilating = alkalosis (think: pH up so ventilation up)
- under = acidosis
ex. a woman is over using their breathing techniques in labour. what are they in?
- respiratory alkalosis
ex. a child who was a victim of near drowing. what are they experiencing?
- respiratory acidosis
