Acid-base Imbalances

Question 1

pH > 7.35

pCO2 > 45 mm Hg

Answer 1

respiratory acidosis

Question 2

S/S of resp acidosis:

somnolence and _______, coma

Answer 2

confusion

Question 3

S/S of resp acidosis:

___________with asterixis

Answer 3

myoclonus

Question 4

S/S of resp acidosis:

___________ cerebral blood flow causes ___________ CSF pressure causing increased ICP

Answer 4

increased

increased

Question 5

Lab:

arterial pH ___ 7.35 in resp acidosis

Answer 5

arterial pH < 7.35

Question 6

Lab:

PCO2 ___ 45 in resp acidosis

Answer 6

PCO2 > 45

Question 7

Lab:

Serum HCO3 ___ 26 in compensated resp acidosis

Answer 7

Serum HCO3 >26 in compensated

Question 8

Mgmt resp acidosis with no obvious cause

Answer 8

Naloxone 0.04 to 2 mg

Question 9

mgmt. of resp acidosis

Answer 9

improve ventilation, intubate if necessary

Question 10

Vent mgmt. of resp acidosis

Answer 10

increase rate of ventilator

Question 11

hyperventilation _______ arterial PCO2 and increases pH in Resp alkalosis

Answer 11

decreases

Question 12

S/S of resp alkalosis:

Answer 12

light headedness
anxiety
paraesthesia
stocking/glove tingling
tetany if severe

Question 13

Lab/diag for resp alkalosis

Answer 13

pH > 7.45

PCO2 < 35 mm Hg

Question 14

Mgmt of resp alk for acute hyperventilation

Answer 14

have pt breathe into a bag

Question 15

Vent mgmt. of resp alk

Answer 15

decrease vent rate, sedation may be needed

Question 16

Rapid correction of resp alkalosis may result in …

Answer 16

resp acidosis

Question 17

Hallmark sign of met acidosis

Answer 17

HCO3 < 26

Question 18

Nml Anion Gap

Answer 18

14 + or - 5

Question 19

Anion Gap calculation

Answer 19

Na - (HCO3 + Cl)

Question 20

The higher the anion gap, the ______ the patient

Answer 20

sicker

Question 21

Anion Gap met acidosis causes

Answer 21

DKA
Alcoholic KA
LA
Drug or chemical anion

Question 22

Non-Anion Gap met acidosis causes

Answer 22

diarrhea
ileostomy
renal tubular acidosis
recovery from DKA

Question 23

Tx for increased anion gap met acidosis

Answer 23

fluid resuscitation
HCO3 generally not indicated if the acidosis is d/t hypoxia or DKA
HCO3 indicated if severe hyperkalemia is present

Question 24

Non-anion Gap Met Acidosis Tx:

Answer 24

Common with chronic conditions like renal failure

Bicitra 10-30 cc with meals and hs