Acid Base Imbalances: Four types

Question 1

Three adaptive mechanisms (first, second, third)

Answer 1

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

Question 2

Chemical buffer system

Answer 2

Primary regulator, immediate action

Question 3

Chemical buffer system action

Answer 3

Chemicals combine with acids and bases to minimize pH changes

Question 4

Chemical buffer system types

Answer 4

Carbonic Acid-Bicarbonate (HCO3)

Protein buffering

Question 5

Respiratory system mechanism

Answer 5

Secondary system

Responds within minutes

Question 6

Action of respiratory system

Answer 6

Elimination or retention of carbon dioxide

Question 7

Renal system mechanism

Answer 7

Secondary system

Responds within 2-3 days

Question 8

Renal system action

Answer 8

Secretion or reabsorption of hydrogen and bicarbonate

Produces more acidic or alkaline urine

Question 9

Respiratory Acidosis

Answer 9

Decrease in alveolar ventilation causing excess carbon dioxide in blood

Question 10

Causes of respiratory acidosis

Answer 10

Inadequate respirations
Respiratory failure
Inadequate blood / gas exchange

Question 11

Causes of inadequate respirations

Answer 11

Pain
Narcotics
Atelectasis
Pneumonia
COPD(chronic obstructive pulmonary disease
Asthma

Question 12

Clinical manifestations of respiratory acidosis

Answer 12

Shallow respirations
Headache and blurred vision
Hypoxia (breathlessness, apprehension)
Mental changes (Disorientation, drowsiness, dizziness)

Question 13

Respiratory acidosis treatment

Answer 13

Treat underlying cause
-treat pain
-reduce narcotic disease
-encourage deep breathing
Administer oxygen

Question 14

Respiratory acidosis compensation

Answer 14

By renal system

• Elimination of hydrogen
• Retention of bicarbonate

Question 15

Respiratory alkalosis

Answer 15

Alveolar hyperventilation

Reduction in plasma CO2 levels

Question 16

Causes of respiratory alkalosis

Answer 16

Anxiety
Fever
Respiratory infections
Pain
Over oxygenation

Question 17

Clinical manifestations of respiratory alkalosis

Answer 17

Mental changes

Numbness and tingling in extremities (dizziness, lightheadedness, confusion)

Question 18

Respiratory alkalosis treatment

Answer 18

• Treat underlying cause
• Encourage slow breathing
• Paper bag breathing
• Sedatives

Question 19

Respiratory alkalosis compensation

Answer 19

By renal system

• Decreases hydrogen excretion
• Decreases bicarbonate reabsorption

Question 20

Metabolic acidosis

Answer 20

Acids increase or bicarbonate is lost

Question 21

Causes of metabolic acidosis

Answer 21

Loss of intestinal contents (diarrhea)
Diabetes
Renal failure

Question 22

Metabolic acidosis clinical manifestations

Answer 22

Kussmaul respirations (blowing off CO2)
Weakness
Nausea and vomiting
Abdominal pain
Mental changes (headache, confusion, lethargy, drowsiness)

Question 23

Treatment for metabolic acidosis

Answer 23

Treat underlying cause

Give IV bicarbonate

Question 24

Compensation for metabolic acidosis

Answer 24

By respiratory system

• Kussmaul respirations
• Attempt to increase pH by “blowing off” CO2

Question 25

Metabolic alkalosis

Answer 25

Excessive loss of acids, increase in bicarbonate

Question 26

Causes of metabolic acidosis

Answer 26

Loss of gastric acid content

Diuretics

Question 27

Clinical manifestations of metabolic alkalosis

Answer 27

Mental changes
Tetany
Tingling in extremities
Tachycardia
Hypoventilation

Question 28

Treatment of metabolic alkalosis

Answer 28

Treat underlying cause

May need fluid replacement

Question 29

Metabolic alkalosis compensation

Answer 29

By respiratory system

Breathing is suppressed to hold CO2