Arterial blood gases section 2

Question 1

Primary determinants of blood gas disorders

Answer 1

pH, PaCO2, HCO3-

Question 2

henderson-hasselbalch equation/ acid base balance

Answer 2

6.1 + log (hco3-)/ (0.03 x PCO2)

Question 3

relationship of H+ ion directly correlated to CO2

Answer 3

and inversely correlated to bicarbonate (HCO3-)

H+ (symbol) PCO2/HCO3-
PCO2 - represents respiratory component
HCO3- represents metabolic and chemical components

Question 4

as co2 increases, so does H+

Answer 4

so CO2/PaCO2 will be the measure of the acid portion of the acid base relationship. and inversely as the bicarbonate goes up, H+ levels goes down, so bicarbonate is base portion of acid base relationship.

Question 5

acid base regulation

Answer 5

respiratory
metabolic
chemical

Question 6

respiratory

Answer 6

15,000 mmol CO2 produced per day
Pulmonary excretion of CO2
Mediated by carotid chemoreceptors (activated by H+)

Question 7

metabolic

Answer 7

50 to 100 mEq nonvolatile acid produced per day
Renal reabsorption of filtered HCO3-
Renal excretion of titratable acid and ammonium

Question 8

chemical

Answer 8

Intracellular and extracellular buffering

• > Phosphate
• > Protein
• > Hemoglobin

Modest effects on HCO3-

Question 9

respiratory

metabolic

Answer 9

acidosis (condition that predisposes a patient to have more acid in body)
alkalosis (condition that predisposes a patient to have more alkaline in body))
ex. respiratory acidosis - disorders in respiratory system drive increases in acid levels
respiratory alkalosis - disorders in the respiratory system drive increases in alkaline levels

Question 10

acidemia (acid condition existing in your blood)

alkalemia

Answer 10

simple (patient has single acid base disorder; ex. they only have respiratory acidosis)
mixed (patient has more than one acid base disorder)

Question 11

acidosis and alkalosis vs acidemia and alkalemia

Answer 11

predisposition vs actual state

Question 12

normal levels of:
pH
PCO2
HCO3-

Answer 12

7.36 - 7.44 (avg 7.4)
36 -44 mm Hg
22 - 26 mEq/L

Question 13

how is pH altered?

Answer 13

decreased = acidosis 
increased = alkalosis

Question 14

how is PaCO2 altered?

Answer 14

opposite direction as pH = respiratory
same direction as pH = metabolic
ex of first one: if pH increases, and if paCO2 decreases, it is respiratory

Question 15

how is hco3- altered?

Answer 15

opposite direction as pH = respiratory

same direction as pH = metabolic