acid base part 2 Flashcards
buffers
primary regulator of acid base
change strong acids into weak ones
present in all body fluids
strong acid + strong base <–> salt + weak acid
Carbonic acid- bicarbonate system and others
major buffer of ECF
phosphate, protein, and hemoglobin buffers also exist
renal system
kidneys reabsorb bicarbonate and excrete acid
excretion methods
- free hydrogen into renal tubule
-combine H with NH3 to form NH4
-excreting weak acids
respiratory acidosis
carbonic acid excess caused by
-hypoventilation
-respiratory failure
Compensation
-kidneys conserve HCO3 and secrete H+
Respiratory Alkalosis
Carbonic acid deficit caused by:
-hypoxemia from acute pulmonary disorders
-hyperventilation
Compensation
-rarely occurs when acute
-can buffer with bicarbonate shift
-renal compensation if chronic
Metabolic acidosis
Excess carbonic acid or base bicarbonate deficit caused by:
-ketoacidosis
-lactic acid accumulation (shock)
-severe diarrhea
-kidney disease
Compensation:
-Increased CO2 excretion by lungs –> Kussmaul
-kidneys excrete acid
Anion gap
- Na - (Cl + HCO3)
-normal is 8-12
-increases with acid gain
metabolic alkalosis
base bicarbonate excess caused by:
-prolonged vomiting or NG suction
-gain of HCO3
Compensation:
-renal excretion of HCO3
-decreased RR to increase CO2 (limited)
Mixed Acid-Base disoreder
2 happening at once
e.g. Resp Acid and Met Alk (atelectasis and NG suction)
e.g. Resp and Met Acid (shock and hypoventilation)
e.g. Resp and Met Alk (hypervent and NG)
Manifestation of Acidosis
tired, confused, dizzy, headache, coma
Resp: Vfib, warm skin, seizures, hypovent
Met: dysrhythmia, cold skin, GI issues, weakness, Deep rapid resps
Manifestations of Alkalosis
Confusion, headache, tachycardia, dysrhythmia, nausia/vomit, tetany, tingling, seizures
Resp: dizzy, stomach pain, numbness, hyperflexia, hypervent
Met: tired and grumpy, anorexia, tremors, cramps, hypovent
