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NRS 232 Pathophysiological Processes - MHCC > Ch 8 Acid Base Imbalance > Flashcards

Ch 8 Acid Base Imbalance Flashcards

1
Q

Body Acids

A

H+ or CO2

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2
Q

Hydrogen is considered a ___

A

donor

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3
Q

An acid is defined as a substance that…

A

dissociates into an H+ and an anion (negatively charged particle)

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4
Q

Normal Blood pH

A

7.35-7.45

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5
Q

pH under 7.35

A

Acidosis
Elevation of H+ concentration of body fluid above normal
OR
decrease in HCO3-

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6
Q

pH above 7.45

A

Alkalosis
Decrease in H+ concentration of body fluid below normal
OR
excess of HCO3-

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7
Q

pH reflects…

A

the measure of acidity/alkalinity in the blood

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8
Q

pH strictly regulated by…

A

lungs and kidneys

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9
Q

pH is the body’s balance of what

A

H+

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10
Q

acidity is measured by…

A

CO2 levels in blood

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11
Q

Bicarbonate is considered a

A

recipient

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12
Q

HCO3- can counteract H+? T/F

A

False, very weak base cannot counteract H+

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13
Q

HCO3-

A

Bicarbonate

  • primary buffer
  • also known as an alkali
  • negatively charged particle looking to associate with an H+
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14
Q

Alkalinity typically measured by

A

HCO3- levels

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15
Q

The higher the pH, the higher the

A

bicarbonate (more alkaline)

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16
Q

Carbonic Acid Cycle

A

[CO2] + [H20]
<> H2CO3 <>
[H+] + [HCO3-]

[acid] + [water]
<> carbonic acid <>
[Hydrogen] + [bicarbonate]

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17
Q

Acidosis causes a shift…

A

to the left

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18
Q

Alkalosis causes a shift…

A

to the right

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19
Q

How do kidneys regulate acid/base?

A

They can retain or excrete H+ or HCO3- as needed to maintain balance

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20
Q

How do lungs regulate CO2 balance?

A
  • hyperventilation decreases CO2, increasing pH (do this when acidotic)
  • hypoventilation increases CO2, decreasing pH (do this when alkalotic)
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21
Q

The body response to acidosis?

A
  • respirations increase, lowering pCO2
  • other buffer systems absorb H+
  • kidneys secrete H+ to raise pH
  • Kidneys generate HCO3- from breaking H+ from carbonic acid
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22
Q

In Metabolic regulation HCO3- is either

A

excreted in urine (acidosis) or reabsorbed in bloodstream (alkalosis)

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23
Q

In respiratory regulation

A

changes in CO2 activate chemical chemoreceptors in the medulla (respiratory center) resulting in an increase or decrease in respirations

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24
Q

Major stimulus for inhalation =

A

CO2 concentration in blood

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25
Q

System responsible for maintaining pH balance___, if they cannot compensate ___ take over

A

Lungs, kidneys

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26
Q

Acid-Base and ____homeostasis are linked

A

potassium

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27
Q

Acidosis often associated with ____ because it causes ___ to move from ___ to ____ in exchange for ____

A

hyperkalemia because if causes potassium to move from the cells into the extracellular fluid in exchange for hydrogen

28
Q

Alkalosis often associated with ____

A

hypokalemia

29
Q

Arterial blood gas

A

the pressure of gases in the bloodstream

-primary concentration of O2 & CO2 in blood

30
Q

Normal pH, measured most typically by concentration of ___ in blood

A

7.35-7.45
CO2
under 7.35 = acidosis
above 7.45 = alkalosis

31
Q

pCO2 values, what is it?

A 
35-45
the pressure of CO2 in arterial blood
respiratory measurement
under 35 = alkalosis
above 45 = acidosis
32
Q

HCO3- values, what is it?

A 
22-26
amount of bicarbonate ion in blood
metabolic measurement
under 22 = acidosis
above 26 = alkalosis
33
Q

paO2 normal values, what is it?

A

90-100

the PRESSURE of oxygen in arterial blood

34
Q

SaO2 normal value, what is it?

A

95%-100%

Saturation of hemoglobin with oxygen

35
Q

Process of acidosis re: homeostasis

A 
Disturbed by DECREASED pH
*Stimulates Brain & arterial Receptors*
↑  Increase Respirations  ↑
←  Excrete CO2  →
↓  Decrease H2CO3 (carbonic acid)  ↓
↑  pH Increase  ↑
Homeostasis restored
36
Q

process of alkalosis re: homeostasis

A 
Disturbed by INCREASED pH
*Stimulates Brain & Arterial Receptors*
↓  Decrease Respirations  ↓
→  Intake CO2  ←
↑  Increase H2CO3 (carbonic acid)   ↑
↓  pH Decrease  ↓
Homeostasis Restored
37
Q

Respiratory Acidosis Values

A

PCO2 greater than 45

Blood pH lower than 7.35

38
Q

Respiratory Acidosis Etiology

A

Failure of respiratory system to remove or exhale CO2 from body fluids as fast as it is produced by cells

39
Q

In Respiratory Acidosis Kidneys…

A

attempt to reabsorb HCO3- and excrete H+

40
Q

Respiratory Acidosis: Causes

A
  • Interference with breathing
  • Emphysema/COPD
  • Respiratory Muscle Weakness
  • Mechanical Issues
  • Overdose
  • Suffocation
  • Neuromuscular disorders
41
Q

Respiratory Acidosis and COPD

A
  • fruity smelling breath”
  • COPD patients have high CO2 in lungs and cannot expel CO2 adequately
  • COPD patients are HYPERCAPNIC and susceptible to acidosis/hypERkalemia
42
Q

Respiratory acidosis pushes carbonic acid cycle to the…

43
Q

Respiratory Acidosis Signs/Symptoms

A 
o	Decreased Respiratory rate
o	Somnolence
o	Cyanosis
o	Shallow or labored breathing
o	Dysrhythmias
44
Q

Respiratory Acidosis Treatments

A

Improve ventilation

  • -intubation
  • -mechanical ventilation
45
Q

Respiratory Alkalosis lab values

A

pCO2 below 35

pH greater than 7.45

46
Q

Respiratory Alkalosis Etiology

A

loss of CO2 from lungs is faster than what is produced by the cells

47
Q

Respiratory Alkalosis pushes carbonic acid cycle to the

48
Q

Respiratory Alkalosis body compensation

A

Kidneys attempt to reabsorb H+ and excrete HCO3-

49
Q

Respiratory Alkalosis Causes

A
  • hyperventilation
  • asthma
  • anxiety
  • pain
  • pulmonary embolism
50
Q

Respiratory Alkalosis SIgns/Symptoms

A
  • Dizziness
  • Lightheadedness
  • parasthesia
  • muscle spasms
  • tachycardia
  • tachypnea
  • hypokalemia
  • deep, rapid respirations
  • confusion
  • lethargy
  • nausea/vomiting
  • seizures
51
Q

Metabolic Acidosis Values

A

pH below 3.75

HCO3- below 22

52
Q

Metabolic Acidosis Body’s attempt to compensate

A

Lungs try and blow off CO2 by hyperventilation

53
Q

Metabolic Acidosis Etiology

A

Abnormal accumulation of acids or loss of bases

54
Q

Metabolic Acidosis Causes

A 
o	Diabetic Ketoacidosis
o	Lactic acidosis
o	Toxins
o	Shock
o	Renal failure causing acid waste build up
o	Kidney disease
o	Diarrhea
o	Vomiting
	Pancreatic HCO3- is lost with prolonged, severe vomiting or diarrhea
55
Q

Metabolic Acidosis Signs/Symptoms

A 
o	Respiratory issues
o	Kussmaul’s breathing (deep, rapid respirations)
o	warm, flushed skin
o	nausea/vomiting/diarrhea
o	headache
o	Disorientation
o	Coma
o	Dysrhythmias
o	Hypotension
56
Q

Metabolic Acidosis Treatment

A

o IV bicarbonate
o Correct underlying issue subsequently causing acidosis
o Fix electrolyte imbalances

57
Q

Metabolic Alkalosis Values

A

pH greater than 7.45

HCO3- greater than 26

58
Q

Metabolic Alkalosis RE: Kidneys

A

If too much base or not enough acid is in the blood, the kidney attempts to retain as much H+ as possible; the kidney will REABSORB H+ instead of its usual K+.

59
Q

___ commonly occurs with metabolic alkalosis

A

Hypokalemia

60
Q

Metabolic Alkalosis Body’s attempt to Compensate

A

lungs slow respirations in an attempt to retain CO2

61
Q

Metabolic Alkalosis Etiology

A

Loss of H+ or addition of base to body fluids

62
Q

Metabolic Alkalosis Causes

A 
o	Excess bicarbonate ingestion
o	Post-code excess bicarb through IV
o	Vomiting of excess gastric acid
o	Cushing’s syndrome (excessive adrenocorticotropic hormone. Excess glucocorticoid use, typically for inflammation)
o	Diuretics
o	Excessive GI suctioning
63
Q

Metabolic Alkalosis Signs/Symptoms

A 
o	Weakness
o	Confusion
o	Dysrhythmias (tachycardia)
o	Paresthesia
o	Lightheadedness
o	Muscle weakness
o	Compensatory Hypoventilation
o	Hypokalemia
64
Q

Metabolic Alkalosis Treatment

A

o Electrolyte replacement

o Acetazolamide

65
Q

Anion Gap is the…

equation:

A

Measurement of the interval between sum of regularly measured cations minus regularly measured anions
• (Na+ + K+) – (Cl- + HCO3-)

66
Q

Anion gap is used to show:

A

whether blood has electrolyte imbalance or acid imbalance

NRS 232 Pathophysiological Processes - MHCC (11 decks)

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