Ch 8 Acid Base Imbalance Flashcards
1
Q
Body Acids
A
H+ or CO2
2
Q
Hydrogen is considered a ___
A
donor
3
Q
An acid is defined as a substance that…
A
dissociates into an H+ and an anion (negatively charged particle)
4
Q
Normal Blood pH
A
7.35-7.45
5
Q
pH under 7.35
A
Acidosis
Elevation of H+ concentration of body fluid above normal
OR
decrease in HCO3-
6
Q
pH above 7.45
A
Alkalosis
Decrease in H+ concentration of body fluid below normal
OR
excess of HCO3-
7
Q
pH reflects…
A
the measure of acidity/alkalinity in the blood
8
Q
pH strictly regulated by…
A
lungs and kidneys
9
Q
pH is the body’s balance of what
A
H+
10
Q
acidity is measured by…
A
CO2 levels in blood
11
Q
Bicarbonate is considered a
A
recipient
12
Q
HCO3- can counteract H+? T/F
A
False, very weak base cannot counteract H+
13
Q
HCO3-
A
Bicarbonate
- primary buffer
- also known as an alkali
- negatively charged particle looking to associate with an H+
14
Q
Alkalinity typically measured by
A
HCO3- levels
15
Q
The higher the pH, the higher the
A
bicarbonate (more alkaline)
16
Q
Carbonic Acid Cycle
A
[CO2] + [H20]
<> H2CO3 <>
[H+] + [HCO3-]
[acid] + [water]
<> carbonic acid <>
[Hydrogen] + [bicarbonate]
17
Q
Acidosis causes a shift…
A
to the left
18
Q
Alkalosis causes a shift…
A
to the right
19
Q
How do kidneys regulate acid/base?
A
They can retain or excrete H+ or HCO3- as needed to maintain balance
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)
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
22
Q
In Metabolic regulation HCO3- is either
A
excreted in urine (acidosis) or reabsorbed in bloodstream (alkalosis)
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
24
Q
Major stimulus for inhalation =
A
CO2 concentration in blood
25
System responsible for maintaining pH balance___, if they cannot compensate ___ take over
Lungs, kidneys
26
Acid-Base and ____homeostasis are linked
potassium
27
Acidosis often associated with ____ because it causes ___ to move from ___ to ____ in exchange for ____
hyperkalemia because if causes potassium to move from the cells into the extracellular fluid in exchange for hydrogen
28
Alkalosis often associated with ____
hypokalemia
29
Arterial blood gas
the pressure of gases in the bloodstream
| -primary concentration of O2 & CO2 in blood
30
Normal pH, measured most typically by concentration of ___ in blood
7.35-7.45
CO2
under 7.35 = acidosis
above 7.45 = alkalosis
31
pCO2 values, what is it?
```
35-45
the pressure of CO2 in arterial blood
respiratory measurement
under 35 = alkalosis
above 45 = acidosis
```
32
HCO3- values, what is it?
```
22-26
amount of bicarbonate ion in blood
metabolic measurement
under 22 = acidosis
above 26 = alkalosis
```
33
paO2 normal values, what is it?
90-100
| the PRESSURE of oxygen in arterial blood
34
SaO2 normal value, what is it?
95%-100%
| Saturation of hemoglobin with oxygen
35
Process of acidosis re: homeostasis
```
Disturbed by DECREASED pH
*Stimulates Brain & arterial Receptors*
↑ Increase Respirations ↑
← Excrete CO2 →
↓ Decrease H2CO3 (carbonic acid) ↓
↑ pH Increase ↑
Homeostasis restored
```
36
process of alkalosis re: homeostasis
```
Disturbed by INCREASED pH
*Stimulates Brain & Arterial Receptors*
↓ Decrease Respirations ↓
→ Intake CO2 ←
↑ Increase H2CO3 (carbonic acid) ↑
↓ pH Decrease ↓
Homeostasis Restored
```
37
Respiratory Acidosis Values
PCO2 greater than 45
| Blood pH lower than 7.35
38
Respiratory Acidosis Etiology
Failure of respiratory system to remove or exhale CO2 from body fluids as fast as it is produced by cells
39
In Respiratory Acidosis Kidneys...
attempt to reabsorb HCO3- and excrete H+
40
Respiratory Acidosis: Causes
- Interference with breathing
- Emphysema/COPD
- Respiratory Muscle Weakness
- Mechanical Issues
- Overdose
- Suffocation
- Neuromuscular disorders
41
Respiratory Acidosis and COPD
- 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
Respiratory acidosis pushes carbonic acid cycle to the...
RIGHT
43
Respiratory Acidosis Signs/Symptoms
```
o Decreased Respiratory rate
o Somnolence
o Cyanosis
o Shallow or labored breathing
o Dysrhythmias
```
44
Respiratory Acidosis Treatments
Improve ventilation
- -intubation
- -mechanical ventilation
45
Respiratory Alkalosis lab values
pCO2 below 35
| pH greater than 7.45
46
Respiratory Alkalosis Etiology
loss of CO2 from lungs is faster than what is produced by the cells
47
Respiratory Alkalosis pushes carbonic acid cycle to the
LEFT
48
Respiratory Alkalosis body compensation
Kidneys attempt to reabsorb H+ and excrete HCO3-
49
Respiratory Alkalosis Causes
- hyperventilation
- asthma
- anxiety
- pain
- pulmonary embolism
50
Respiratory Alkalosis SIgns/Symptoms
- Dizziness
- Lightheadedness
- parasthesia
- muscle spasms
- tachycardia
- tachypnea
- hypokalemia
- deep, rapid respirations
- confusion
- lethargy
- nausea/vomiting
- seizures
51
Metabolic Acidosis Values
pH below 3.75
| HCO3- below 22
52
Metabolic Acidosis Body's attempt to compensate
Lungs try and blow off CO2 by hyperventilation
53
Metabolic Acidosis Etiology
Abnormal accumulation of acids or loss of bases
54
Metabolic Acidosis Causes
```
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
Metabolic Acidosis Signs/Symptoms
```
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
Metabolic Acidosis Treatment
o IV bicarbonate
o Correct underlying issue subsequently causing acidosis
o Fix electrolyte imbalances
57
Metabolic Alkalosis Values
pH greater than 7.45
| HCO3- greater than 26
58
Metabolic Alkalosis RE: Kidneys
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
___ commonly occurs with metabolic alkalosis
Hypokalemia
60
Metabolic Alkalosis Body's attempt to Compensate
lungs slow respirations in an attempt to retain CO2
61
Metabolic Alkalosis Etiology
Loss of H+ or addition of base to body fluids
62
Metabolic Alkalosis Causes
```
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
Metabolic Alkalosis Signs/Symptoms
```
o Weakness
o Confusion
o Dysrhythmias (tachycardia)
o Paresthesia
o Lightheadedness
o Muscle weakness
o Compensatory Hypoventilation
o Hypokalemia
```
64
Metabolic Alkalosis Treatment
o Electrolyte replacement
| o Acetazolamide
65
Anion Gap is the...
| equation:
Measurement of the interval between sum of regularly measured cations minus regularly measured anions
• (Na+ + K+) – (Cl- + HCO3-)
66
Anion gap is used to show:
whether blood has electrolyte imbalance or acid imbalance
