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P&A II final > Alteration in Acid/Base Balance > Flashcards

Alteration in Acid/Base Balance Flashcards

1
Q

How does the body repair a respiratory issue?

A

Kidneys

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2
Q

How does the body repair a metabolic issue?

A

Lungs

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3
Q

How is pH of the body maintained?

A

Buffers via elimination of acids through lungs and kidneys

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4
Q

What are the chemical buffers of the body?

A

CO2 (acidic)

HCO3 (alkalotic)

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5
Q

How do the lungs compensate?

A

By controlling the amount of CO2 in the blood

Immediate response

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6
Q

How do the kidneys compensate?

A

By changing the rate of excretion or retention of H+ and HCO3- ions
“Slow” response

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7
Q

What will happen if the metabolic side is too acidic?

A

Body will breathe faster and blow off CO2 (acid)

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8
Q

What will happen if the metabolic side is too alkalotic?

A

Body will slow down breathing and hold on to CO2 (acidic)

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9
Q

What happens when the body is too alkalotic?

A

At distal tubules (where reabsorption takes place), the body will reabsorb H+ and excrete HCO3 (alkalotic)

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10
Q

What happens when the body is too acidic?

A

At distal tubules, the body will reabsorb HCO3 and excrete H+

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11
Q

What is chemical regulation?

A

Plasma protein buffer where albumin, fibrinogen, prothrombin, and gamma globulin can bind with H+ to correct acidosis or alkalosis
(Limited binding capacity)

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12
Q

What is biological regulation?

A

When H+ ions are absorbed or released by body cells

H+ must be changed with another + ion (often K+)

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13
Q

When can biological regulation occur?

A

After short term chemical buffering

Takes 2-4 hours

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14
Q

What are the physiological buffers?

A

Lungs - rapid adaptation

Kidneys - slower

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15
Q

What is a normal pH?

A

7.35-7.45

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16
Q

What is a normal paCO2?

A

35-45

17
Q

What is a normal HCO3-?

A

22-26

18
Q

What is a normal paO2?

A

80-100

19
Q

What is a normal saO2?

A

95-99%

20
Q

What values are acidotic?

A

pH <7.35
CO2 >45
HCO3 <22

21
Q

What values are alkalotic?

A

pH >7.45
CO2 <35
HCO3 >26

22
Q

What factors affects acid-base balance?

A 
Age (old and young)
Chronic disease
Trauma
Therapies
GI losses
23
Q

What occurs in respiratory acidosis?

A

Decreased pH <7.35
Increased CO2 >45
Increase in H+ ions
Caused by hypoventilation or depressed ventilation
Results in hypoxemia
Compensation is a result of increased HCO-3
May be seen with an increased K+ > 5.0

24
Q

What does respiratory acidosis lead to?

A

Hypoxemia
CSF & brain cells become acidotic
- Change in LOC

25
Q

What is ROME?

A

Respiratory opposite

Metabolic equal

26
Q

High pH and low CO2 = ?

A

Respiratory problem

27
Q

Low pH and high CO2 = ?

A

Respiratory problem

28
Q

Low pH and low HCO3 = ?

A

Metabolic problem

29
Q

High pH and high HCO3 = ?

A

Metabolic problem

30
Q

What causes respiratory acidosis?

A 
Pneumonia
Renal failure
Atelectasis
Drug OD
Paralysis of respiratory muscles
Trauma
Obstructive Sleep Apnea
Airway obstruction
Head injury
Stroke (CVA)
*things that make one breathe slowly
31
Q

What occurs in respiratory alkalosis?

A

Increased pH >7.45
Decreased CO2 <35
Decreased H+ ions
Caused by HYPERventilation with excessive exhalation of CO2
Compensation is a result of a decrease in HCO-3
May be seen with a decreased K+ <3.5

32
Q

What causes respiratory alkalosis?

A 
Anxiety
Fear
Anemia
Increased metabolic states
CNS injury
Asthma
*things that make one hyperventilate
33
Q

Why does anemia cause respiratory alkalosis?

A

Causes one to breathe quickly because there’s decreased RBC and HgB carries oxygen

34
Q

What occurs in metabolic acidosis?

A 
Decreased pH <7.35
Decreased HCO-3 < 22
Increased H+ ions
Compensation is a result of decrease in CO2 <35
May be seen with K+ >5.0
35
Q

What causes metabolic acidosis?

A 
Starvation
DKA
Renal failure
Shock
Diarrhea (main cause)
36
Q

What occurs in metabolic alkalosis?

A

Increased pH >7.45
Increased HCO-3 > 26
Decreased H+ ions
Compensation is a result of increase in CO2 > 45

37
Q

What causes metabolic alkalosis?

A 
Excessive use of antacids
Prolonged gastric suctioning
Loss of gastric acidic juices
Excessive or prolonged vomiting
Hypokalemia (< 3.5)
Main cause: loss of upper GI fluids
38
Q

What is the nursing process for ABG stuff?

A 
Assessment
- Look at RR, O2 sat
- Difficulty? Accessory muscles to breathe? Diaphragmatic breathing/nasal flaring?
Nursing diagnoses
Planning 
Implementing
Evaluation
39
Q

How do you determine if the issue is with resp or metabolic?

A

Compare pH with CO2 and HCO3
If pH is acidotic, look for whichever value is also acidotic
If pH is alkalotic, look for whichever value is also alkalotic

P&A II final (6 decks)

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