Ch 14 Acid Base Imbalance

Question 1

Normal PaO2

Answer 1

80-100 mmHg

Question 2

Normal PaCo2

Answer 2

35-45 mmHg

Question 3

Normal bicarbonate

Answer 3

21-28 mEq/L

Question 4

Normal Lactate

Answer 4

3-7 mg/dl

Question 5

What organ controls bicarbonate levels?

Answer 5

Kidneys

Question 6

Fatal pH levels

Answer 6

less than 6.9 or above 7.8

Question 7

4 causes of metabolic acidosis

Answer 7

overproduction of H ions (DKA or starvation), anaerobic glucose breakdown (lactic acidosis, seizures, fever) and excessive intake of acids (alcohol, aspirin)
under elimination of H ions- kidney failure causes decreased secretion
underproduction of bicarbonate ions- due to renal , pancreas, or liver failure
over elimination of bicarcbonate ions- due to diarrhea

Question 8

Lab results of metabolic acidosis

Answer 8

pH ↓ HCo3↓ PaCo2 is normal

Question 9

Respiratory acidosis

Answer 9

caused by Co2 retention

Question 10

Causes of respiratory acidosis

Answer 10

Poor gas exchange

pneumonia, TB, emphysema, pulmonary emboli or edema

Question 11

Lab results of respiratory acidosis

Answer 11

pH↓ HCo3 normal PaCo2 ↑ if acidosis is chronic, HCO3 will be elevated because it is trying to compensate

Question 12

Manifestations of acidosis

Answer 12

similar to hyperkalemia

lethargy, muscle weakness, hypotension, bradycardia, Kussmauls respirations

Question 13

Skin manifestations with metabolic acidosis

Answer 13

skin will be warm, flushed and dry

Question 14

Skin manifestations with respiratory acidosis

Answer 14

skin will be pale or cyanotic and dry

Question 15

Cause of metabolic alkalosis

Answer 15

an increase of bases (increased intake of oral antacids or massive blood transfusions) or a decrease of acids (prolonged vomiting, excess cortisol, hyperaldosteronism, diuretics, prolonged suctioning)

Question 16

Causes of respiratory alkalosis

Answer 16

caused by excessive loss of CO2 through hyperventilation d/t anxiety, fear, fever, salicylates or improper settings on ventilators

Question 17

Manifestations of alkalosis

Answer 17

> activity
anxiety
seizures
\+ Trousseus and Chvostecks sign
muscle cramps
> HR, < BP

Question 18

Changes to breathing with respiratory alkalosis

Answer 18

increased rate and depth of respirations

Question 19

Changes to breathing with metabolic alkalosis

Answer 19

decreased respiratory effort

Question 20

Lab results in metabolic alkalosis

Answer 20

pH ↑ HCO3 ↑ CO2 normal

Question 21

Lab results in respiratory alkalosis

Answer 21

pH ↑ HCO3 normal CO2 ↓