Alteration in Acid/Base Balance Flashcards
How does the body repair a respiratory issue?
Kidneys
How does the body repair a metabolic issue?
Lungs
How is pH of the body maintained?
Buffers via elimination of acids through lungs and kidneys
What are the chemical buffers of the body?
CO2 (acidic)
HCO3 (alkalotic)
How do the lungs compensate?
By controlling the amount of CO2 in the blood
Immediate response
How do the kidneys compensate?
By changing the rate of excretion or retention of H+ and HCO3- ions
“Slow” response
What will happen if the metabolic side is too acidic?
Body will breathe faster and blow off CO2 (acid)
What will happen if the metabolic side is too alkalotic?
Body will slow down breathing and hold on to CO2 (acidic)
What happens when the body is too alkalotic?
At distal tubules (where reabsorption takes place), the body will reabsorb H+ and excrete HCO3 (alkalotic)
What happens when the body is too acidic?
At distal tubules, the body will reabsorb HCO3 and excrete H+
What is chemical regulation?
Plasma protein buffer where albumin, fibrinogen, prothrombin, and gamma globulin can bind with H+ to correct acidosis or alkalosis
(Limited binding capacity)
What is biological regulation?
When H+ ions are absorbed or released by body cells
H+ must be changed with another + ion (often K+)
When can biological regulation occur?
After short term chemical buffering
Takes 2-4 hours
What are the physiological buffers?
Lungs - rapid adaptation
Kidneys - slower
What is a normal pH?
7.35-7.45
What is a normal paCO2?
35-45
What is a normal HCO3-?
22-26
What is a normal paO2?
80-100
What is a normal saO2?
95-99%
What values are acidotic?
pH <7.35
CO2 >45
HCO3 <22
What values are alkalotic?
pH >7.45
CO2 <35
HCO3 >26
What factors affects acid-base balance?
Age (old and young) Chronic disease Trauma Therapies GI losses
What occurs in respiratory acidosis?
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
What does respiratory acidosis lead to?
Hypoxemia
CSF & brain cells become acidotic
- Change in LOC
What is ROME?
Respiratory opposite
Metabolic equal
High pH and low CO2 = ?
Respiratory problem
Low pH and high CO2 = ?
Respiratory problem
Low pH and low HCO3 = ?
Metabolic problem
High pH and high HCO3 = ?
Metabolic problem
What causes respiratory acidosis?
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
What occurs in respiratory alkalosis?
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
What causes respiratory alkalosis?
Anxiety Fear Anemia Increased metabolic states CNS injury Asthma *things that make one hyperventilate
Why does anemia cause respiratory alkalosis?
Causes one to breathe quickly because there’s decreased RBC and HgB carries oxygen
What occurs in metabolic acidosis?
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
What causes metabolic acidosis?
Starvation DKA Renal failure Shock Diarrhea (main cause)
What occurs in metabolic alkalosis?
Increased pH >7.45
Increased HCO-3 > 26
Decreased H+ ions
Compensation is a result of increase in CO2 > 45
What causes metabolic alkalosis?
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
What is the nursing process for ABG stuff?
Assessment - Look at RR, O2 sat - Difficulty? Accessory muscles to breathe? Diaphragmatic breathing/nasal flaring? Nursing diagnoses Planning Implementing Evaluation
How do you determine if the issue is with resp or metabolic?
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
