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Patho > Acid-Base Imbalances > Flashcards

Acid-Base Imbalances Flashcards

1
Q

extracellular fluid (ECF)

A

fluid outside cell

20% of body wt.

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2
Q

TBW

A

sum of fluids w/in body

60% of body wt.

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3
Q

interstitial fluid

A

fluid around cells

outside bld vessels

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4
Q

intravascular fluid

A

blood plasma

w/in bld vessels

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5
Q

intracellular fluid (ICF)

A

fluid inside cell

40% of body wt.

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6
Q

diffusion

A

mvmt of charged/noncharged particles along conc. gradient

high to low conc.

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7
Q

osmosis

A

passive mvmt of water across semi-permeable membrane

low to high conc.

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8
Q

osmotic pressure

A

pressure required to stop osmotic flow of water

determined by solutes, osmolality, and osmolarity

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9
Q

osmolality

A

conc of mlcls per wt.

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10
Q

osmolarity

A

conc of mlcls per L

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11
Q

hydrostatic pressure

A

force of water pushing against cellular membranes

force that moves water out

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12
Q

oncotic pressure

A

pressure exerted by colloids- plasma proteins

draws water

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13
Q

inc oncotic pressure

A

draws water out to vasc. space

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14
Q

mvmt of water b/w ICF and ECF

A

occurs by osmotic forces
Na- ECF osmotic balance
K- ICF osmotic balance

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15
Q

mvmt of water b/w plasma and interstitial fluid

A

occurs due to changes in hydrostatic pressure (pushes water out of caps) and osmotic forces (pulls water in caps)

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16
Q

edema

A

accumulation of fluid in interstitial spaces.

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17
Q

etiology of edema

A

inc hydrostatic press
dec plasma oncotic press- give albumin
inc cap permeability
obstructed lymph flow

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18
Q

regulation of body water

A

thirst

renal- ADH

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19
Q

what is thirst stimulated by

A

hyperosmolality, low k, dec BV

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20
Q

how does renal- ADH regulate body water

A

ADH causes kidneys to retain water.

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21
Q

what is renal- ADH controlled by

A

osmolality and volume

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22
Q

when is ADH secreted

A

when osmolality inc, BV dec

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23
Q

normal osmolality

A

280-294

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24
Q

for excess water

A

274

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25
Q

for concentrated fluids, deficit of fluids

A

299

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26
Q

ECF deficit shows what

A

inc osmolality

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27
Q

what does inc osmolality mean

A

lots of particles in bld, not a lot of fluid

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28
Q

etiology of ECF deficit

A

dec intake

inc loss

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29
Q

CM for ECF deficit

A 
thirst
 weight loss
 dec UO
 inc HR
 weakness
 shock
 dec plasma vol
 dec vasc vol
 tired
 weak pulse
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30
Q

treatment for ECF deficit

A

give fluid- water or IV

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31
Q

ECF excess shows what

A

dec osmolality (<280)

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32
Q

etiology of ECF excess

A

inc intake, dec loss

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33
Q

CM for ECF excess

A 
weight gain
peripheral edema
SOB
 abd distention
 seizures, coma, swollen brain cells
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34
Q

treatment for ECF excess

A

diuretics, water restrictions, depends on underlying problem

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35
Q

function of elytes

A

regulate water balance, needed for enzymatic rxns, acid-base balance

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36
Q

function of Na

A

maintain osmolality of ECF, neuromuscular function, acid-base.

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37
Q

Na regulated by

A

aldosterone

dec Na= inc aldosterone= Na retention.

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38
Q

how do we lose Na

A

sweat, urine, bowel

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39
Q

how do we get Na

A

diet

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40
Q

hyponatremia

A

deficient Na

41
Q

etiology of hyponatremia

A

excess water intake/gain
dec water loss
inc Na loss

42
Q

CM for hyponatremia

A 
weight gain
 neuro changes (confusion, lethargy, coma)
HA
GI disturbances
 inc intracellular fluid
43
Q

treatment for hyponatremia

A 
fluid restrictions (H20)
inc Na intake (food, IV)
44
Q

hypernatremia

A

excess Na

45
Q

etiology of hypernatremia

A

inc water loss
dec intake of water
excess Na

46
Q

CM of hypernatremia

A 
thirst
dry mucus membranes
inc HR
restlessness
dehydration
agitation
47
Q

treatment for hypernatremia

A

Na restrictions

IV fluid low in Na followed by diuretics

48
Q

function of K

A 
osmolarity of ICF
 neuromuscular control and regulation
 acid-base balance
 enzyme rxn
 HR
49
Q

how do we get K

A

diet

50
Q

how do we lose K

A

from kidneys- urine

51
Q

hypokalemia

A

deficient K

52
Q

etiology of hypokalemia

A

dec intake
excess GI loss
excess renal loss
intracellular shift- alkalosis

53
Q

CM for hypokalemia

A 
cardiac dysrhythmias
weakness
 dec GI motility
PVC
fatigue
sm. muscle weakness/skel. muscle weakness
confusion
54
Q

treatment for hypokalemia

A

give K

IV fluids that contains K supplements

55
Q

hyperkalemia

A

excess K

56
Q

etiology of hyperkalemia

A

excess intake/gain
dec renal loss
extracellular shift- acidosis

57
Q

most common cause of hyperkalemia

A

dec renal loss

58
Q

CM for hyperkalemia

A 
EKG changes
cardiac arrest
muscle weakness
arrythmias
PVC
inc sm. muscle activity
diarrhea
cramping
59
Q

treatment for hyperkalemia

A

dec K in fluid/foods
diuretics (NOT IF HAVE RENAL FAILURE)
insulin
oral solution- resin

60
Q

what happens when K is too high

A

fatal

61
Q

acidosis

A

process causing acidemia

acid condition of blood pH < 7.35

62
Q

alkalosis

A

process causing alkalemia

alkaline condition of blood pH > 7.45

63
Q

regulation of pH

A

carbonic acid- bicarbonate buffering

respiratory or metabolic

64
Q

respiratory mech. of regulating pH

A

regulates level of C02= acid

65
Q

resp. acidosis

A

inc C02 due to hypoventilation

66
Q

resp. alkalosis

A

dec C02 due to hyperventilation

67
Q

metabolic mech. of regulating pH

A

regulate bicarb (HC03)= base

68
Q

metab. alkalosis

A

inc bicarb

69
Q

metab. acidosis

A

dec bicarb

70
Q

normal pH level

A

7.35 - 7.45

71
Q

normal paC02

A

35 - 45

72
Q

normal bicarb

A

22 - 26

73
Q

patho of respiratory acidosis

A

retain C02 so pH < 7.35

74
Q

etiology of respiratory acidosis

A

hypoventilation

75
Q

CM for respiratory acidosis

A 
depressed CNS
confusion
 HA
 weakness
twitching
shallow respiration
76
Q

compensation for respiratory acidosis

A

acid urine

77
Q

treatment for respiratory acidosis

A

hyperventilate
inc breathing
bronchodilators
get out C02

78
Q

respiratory alkalosis

A

blow off C02 so pH > 7.45

79
Q

etiology of respiratory alkalosis

A

hyperventilation

80
Q

CM for respiratory alkalosis

A

excited CNS- dizzy, confused
numb/tingly toes/fingers
palpitations
sweating

81
Q

compensation for respiratory alkalosis

A

alkaline urine- lose bicarb

82
Q

treatment for respiratory alkalosis

A

inc C02

paper bag

83
Q

metabolic acidosis

A

retain acid so HC03 dec, pH < 7.35

84
Q

etiology of metabolic acidosis

A 
renal failure
diarrhea
shock (lactic acid)
severe hypoxia
ketoacidosis (excess glucose)
85
Q

CM for metabolic acidosis

A 
SAME AS RESP. ACIDOSIS
depressed CNS
weak
fatigue
confusion
86
Q

compensation for metabolic acidosis

A

inc RR
Kussmaul respirations
acid urine

87
Q

treatment for metabolic acidosis

A

treat underlying problem

give Na bicarb to keep acid-base balanced (IV or tablet)

88
Q

metabolic alkalosis

A

loss of acid so HC03 inc, pH > 7.45

89
Q

etiology of metabolic alkalosis

A 
ingestion of base
excessive use of antacids
vomitting
excess aldosterone
diuretic therapy
90
Q

CM for metabolic alkalosis

A 
RELATED TO RESP ALKALOSIS
excited CNS (tingling, cramping)
hyperreflexes
convulsions
weakness
confusion
91
Q

which acid-base imbalance is least common

A

metabolic alkalosis

92
Q

compensation for metabolic alkalosis

A

dec RR

alkaline urine

93
Q

treatment for metabolic alkalosis

A

self-correcting
ID cause
restore fluid balance

94
Q

normal Pa02 level

A

80-100

95
Q

ABG

A

arterial blood gases

tells us C02, 02, pH, bicarb

96
Q

steps to analyzing ABG

A
  1. look at pH- acidemia or alkalemia
  2. find primary cause- look at PaC02 and HC03
  3. look at other values to see if compensation
97
Q

if C02 off and matches pH change

A

respiratory

98
Q

if HC03 off and matches pH change

A

metabolic

Patho (8 decks)

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