Acidosis and Alkalosis Flashcards
Fat tissue holds ______ water so obese people hold _______
less
Lower water content by weight
Fluid compartments for average 70 kg man
25 L ICF
15 L ECF (10 interstital and 5 blood)
As water passed from blood to urine _____
Water replenished from ICF
ICF higher electrolytes
Potassium, inorganic phisphate
ECF Higher electrolyters
Na, Cl, HCO3
mEq equation
mmol X Abs(charge)
Buffers consist of
Weak acid and conjugate base
Buffers can compensate
WIthin 1 pH unit of pKa of acid
3 sources of acids in adults
Non-volatile (digestive)
Organic (normal metabolism)
CO2 (from O2 use by muscles)
CO2 combines with _____ to form _____
H2O
H2CO3
Non-volatile acids quantity
Minor (50-100 mEq)
Organic acids concentration
Thousands of mmol per day
Metabolized to neutral organic compounds
Organic acid concentration of ECF
Low and at steady state
Carbon dioxide is ____
major buffering system of ECF
Acid base balance from rapid to long-term
Normal pulmonary excretion of CO2
Metabolic utilization of organic acids
Renal excretion of non-volatile acids
Acidemia vs. acidosis (same with alkalosis and alkalemia()
Acidemia - blood pH below normal range
Acidosis - process that lowers ECF pH
Metabolic acidosis/alka
Changes serum HCO3 concentrations and pH
Metabolic acid/alk response
Respiratory response moving pCO2 in same direction as HCO3 change
Respiratory acid/alk
CHanges arterial CO2 and pH
Respiratory response
Initial - Change in HCO3 by buffering
Later - Renal response changing HCO3 in same direction of pCO2
Met acid - cause and response
cause - HCO3 dec
Resp - pCO2 dec via resp
Resp acidosis cause and resp
cause - pCO2 inc
Acute - HCO3 inc via buffer
Chronic - HCO3 inc via renal
Met alkalosis - cause and response
Cause - HCO3 inc
Resp - pCO2 in via resp
Resp alkalosis - cause and response
Cause - pCO2 dec
Acute - HCO3 dec via buffer
Chronic - HCO3 dec via renal
hyperventaltion incdicates
metabolic acidosis
Deeper, slower breaths indicates
Metabolic alkalosis
Initial diagnosis
Serum electorlyters (HCO3)
Definitive diagnosis
Serum pH and pCO2
Essential to collect
Patient hisotry
Vomiting causes
Metabolic alkalosis
Hypovolemia (what is it and what does it cause)
Low volume from diarrhea
Lactic acidosis
Aspirin poisoning
Acidosis
SID
Strong ion difference
Cation - anion
Decrease in SID difference causes
acidosis
Mechanism of SID changing pH
POsitive charges must equal negative…body compensates by increasing H+ ions
Hyperchloremic acidosis
Caused often from fluid resusciation
How to avoid SID changes
Ringer’s/Hartmann’s solutions
Ringers - bicarb
Hartmann’s - lactate
Replaces Cl with something else
