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Cardiopulmonary A & P > Chap 7 > Flashcards

Chap 7 Flashcards

1
Q

Normal arterial pH range is 7.35 to 7.45

A

Venous pH range is 7.30 to 7.40

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2
Q

alkalosis

A

ph greater than 7.45, blood has an excess amount of bicarbonate ions

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3
Q

acidosis

A

ph below 7.35, blood has an excess amount of hydrogen ions

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4
Q

Hydrogen ions originate from

A
  1. the breakdown of phosphorous containing proteins 2. the anaerobic metabolism of glucose 3. the metabolism of body fats 4. the transport of CO2 in the blood as HCO liberates H ions
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5
Q

ph regulated by the following what major systems

A

the chemical buffer system, the respiratory system, and the renal system

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6
Q

chemical buffer system

A

responds within a fraction of a second to resist pH changes and is called the first line of defense.

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7
Q

Chemical buffer composed of

A
  1. the carbonic acid-bicarbonate buffer system 2. the phosphate buffer system 3. the protein buffer system….the chemical buffer system inactivates hydrogen ions and liberates HCO ions in response to acidosis or generates more H ions and decreases the concentration of HCO ions in response to alkalosis
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8
Q

respiratory system acts within

A

1 to 3 minutes by increasing or decreasing the breathing depth and rate to offset acidosis or alkalosis, respectively.

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9
Q

in response to metabolic acidosis, the resp system causes

A

the depth and rate of breathing to increase, causing the bodys CO2 to decrease and the pH to increase.

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10
Q

in response to metabolic alkalosis, the respiratory system causes

A

the depth and rate of breathing to decrease, causing the bodys CO2 to increase and the pH to decrease.

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11
Q

bodys most effective acid-base balance monitor and regulator

A

Renal system

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12
Q

Renal system requires how long to correct abnormal pH concentrations

A

a day or more

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13
Q

when the extracellular fluids become acidic the renal system

A

retains HCO and excretes H ions into the urine causing th pH to increase

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14
Q

when the extracellular fluids become alkaline the renal system

A

the renal system retains H and excretes basic substances (HCO) into the urine causing the pH to decrease

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15
Q

Acids and bases

A

are electrolytes. thus, both are acids and bases can ionize and dissociate in water and conduct an electrical current

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16
Q

acids taste

A

sour

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17
Q

acids can react

A

with many metals, and can “burn” a hole through clothing.

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18
Q

Acids release

A

hydrogen ions in measurable amounts, defining acids as proton donors

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19
Q

Proton donors

A

when acids dissolve in a water solution, they release hydrogen ions (protons_ and anions

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20
Q

The acidity of a solution is directly related to

A

the concentration of protons. in other words, the acidity of a solution reflects only the free hydrogen ions, not those bound to anions

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21
Q

hydrochloric acid (HCI)

A

the acid found in the stomach that works to aid digestion

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22
Q

HCL-> H+ Cl-

A

hydrochloric acid

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23
Q

strong acids

A

which dissociate completely and irreversibly in water, dramatically change the pH of the solution.

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24
Q

Weak acids

A

do not dissociate completely in a solution and therefore have a much smaller effect on pH. However, even though they have a relatively small effect on changing pH levels, they have a very important role in resisting sudden pH changes

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25
Q

Examples of weak acids

A

carbonic acid and acetic acid

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26
Q

Proton acceptors

A

bases

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27
Q

bases taste/ feel

A

taste bitter and feel slippery

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28
Q

base is a substance that

A

takes up hydrogen ions in measurable amounts

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29
Q

Bicarbonate ion

A

is an important base in the body and is especially abundant in the blood

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30
Q

ammonia

A

a natural waste product of protein breakdown, is also a base. Has a pair of unshared electrons that strongly attract protons

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31
Q

Strong bases (hydroxides)

A

dissociates easily in water and quickly tie up H+

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32
Q

Weak bases (sodium bicarbonate or baking soda)

A

dissociate incompletely and reversibly and are slower to accept protons. since sodium bicarbonate accepts a relatively small amount of protons, its released bicarbonate ion is described as a weak base

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33
Q

as the concentration of H in a solution increases, the solution becomes

A

more acidic

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34
Q

as the level of hydroxide ions increase, the solution becomes more

A

basic, or alkaline

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35
Q

pH units

A

the concentration of hydrogen ions in the body measurement

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36
Q

pH scale

A

runs from 0-14 and is logarithmic, which means each successive unit change in pH represents a tenfold change in H ion concentration.

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37
Q

buffer action

A

the ability of an acid-base mixture to resist sudden changes in pH. Works against sudden and large changes in the pH of body fluids by releasing H ions

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38
Q

three major chemical buffer systems

A

carbonic acid-bicarbonate buffer system, phosphate buffer system, and the protein buffer system

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39
Q

Carbonic acid-bicarbonate buffer system

A

plays an extremely important role in maintaining pH homeostasis of the blood

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40
Q

under normal conditions, what is the ratio between HCO and H2CO in the blood

A

20:1

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41
Q

Henderson-Hasselbalch Equation

A

illustrates how the pH of a solution is influenced by the HCO to H2CO ratio (base to acid ratio)

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42
Q

Under normal conditions the 20:1 acid-base balance in the body is automatically regulated by the

A

chemical buffer systems, the respiratory system, and the renal system. however, these normal acid-base regulating systems have their limits

43
Q

Common acid-base disturbance classifications

A

Respiratory Acid-Base Disturbance, Metabolic Acid-Base Disturbance

44
Q

Acute Ventilatory falure

A

acute hypoventilation caused by an overdose of narcotics or barbiturates

45
Q

common causes of Respiratory Acidosis/ acute ventilatory failure

A

Chronic obstructive pulmonary disorders, drug overdose, general anesthesia, head trauma, nerologic disorders

46
Q

Acute ventilatory failure/ Respiratory Acidosis

A

also called acute respiratory acidosis is a medical emergency, needs immediate ventilatory assistance

47
Q

In the pt who hypoventilates for a long period of time (chronic obstructive pulm disease)

A

the kidneys will work to correct the decreased pH by retaining HCO in the blood

48
Q

Common causes of Respiratory Alkalosis/ acute alveolar hyperventilation

A

hypoxia, pain, anxiety, and fever, brain inflammation, stimulant drugs

49
Q

Common causes of Metabolic Acidosis

A

lactic acidosis (fixed acids), Ketoacidosis (fixed acids), renal failure, Uncontrolled diarrhea

50
Q

Metabolic acidosis is caused by either the loss of

A

HCO or the accumulation of fixed acids or metabolic acids are produced from sources other than carbon dioxide

51
Q

Anaerobic Metabolism

A

an alternative biochemical reaction occurs that does not use oxygen . lactic is the by product of this process

52
Q

Common causes of metabolic alkalosis

A

Hypokalemia, hypochoremia, gastric suction or vomiting, excessive administration of coricosteroids, excessive administration of sodium bicarbonate, diuretic therapy, hypovelemia

53
Q

During acute alveolar hypoventilation, the blood 1.HCO increases 2.pH increases 3.HCO3 increases 4.PCO2 increases

A

1,2, and 3

54
Q

the bulk of the CO2 produced in the cells is transported to the lungs as

A

HCO3

55
Q

During acute alveolar hyperventilation, the blood

A

H2CO3 decreases

56
Q

in chronic hypoventilation, renal compensation has likely occured when the

A

HCO3 is higher than expected for a particular PCO2, pH is higher than expected for a particular PCO2

57
Q

when metabolic acidosis is present, the patients blood

A

pH is lower than expected for a particular PCO2 and HCO3 is lower than expected for a particular PCO2

58
Q

Ketoacidosis can develop from

A

an inadequate serum insulin level, an inadequate serum glucose level

59
Q

metabolic alkalosis can develop from

A

hypokalemia, hypochoremia

60
Q

which of the following HCO3 to H2CO3 ratios represents an acidic pH? 1.) 18:1 2.) 28:1 3.) 12:1 4.) 22:1

A

1 and 3 only

61
Q

if a patient has a level of 70 torr what is the H2CO3 concentration

A

1.7 mEq/L

62
Q

The value of the pK in the Henderson-Hasselbalch equation is

A

6.1

63
Q

Metabolic acidosis caused by a decreased HCO3 is often called

A

Hyperchloremic Metabolic Acidosis

64
Q

Metabolic Acidosis caused by fixed acids is present when the anion gap is greater than

A

14 mEq/L

65
Q

PaO2 levels

A

80-100 normal, 60-80 mild hypoxia, 40-60 moderate hypoxia, >40 severe hypoxia

66
Q

Causes of respiratory alkalosis

A

Hyperventilation or anxiety and trauma or pain

67
Q

PaCO2 levels

A

35-45, fast to compromise by blowing of CO2

68
Q

HCO3

A

22-28 never compromises right away

69
Q

strong bases

A

dissociate easily in H20 and quickly tie up H

70
Q

Weak Bases

A

dissociate incompletely and reversibly and are slower to accept protons

71
Q

proton acceptors

A

bases

72
Q

weak acids examples

A

Carbonic acid (H2CO3) and acetic acid

73
Q

RBC value

A

4.7-6.1 million

74
Q

Hematocrit value

A

42-52%

75
Q

HCO2 values

A

arterieal 22-28mEq/L, Venous 24-30mEq/L

76
Q

Hgb values

A

12-16 g/100mL

77
Q

Carbon Dioxide Transport

A

metabolizing tissue cells consume approximately 250 ml/min of oxygen and produce approx 200ml/min of CO2 at rest

78
Q

Plasma Transport

A

Carbamino Compound (bound to protein)= 1%, Bicarbonate= 5%, Dissolved CO2= 5%

79
Q

Hydrolysis

A

CO2 + H2O

80
Q

Plasma Transport CO2 + H2O -> H2CO3->

A

H+ + HCO3 (reverse formula when blood reaches the alveoli)

81
Q

Dissolved CO2 can be measured in

A

the venous blood to report the PvCO2

82
Q

H2CO3 concentration can be determined by

A

multiplying the PCO2 x 0.003

83
Q

RBC Transport %

A

Dissolved CO2= 5%, Carbamino-Hgb= 21%, bicarbonate= 63%

84
Q

Haldane effect

A

decreased SaO2 promotes loading of CO2 and increased loading of O2 promotes CO2 release

85
Q

Carbonic Anhydrase (CA)

A

acts as the catalyst to speed the reaction up, biggest carrier of CO2

86
Q

RBC transport CO2 + H2O -> CA-> H2CO3 ->

A

H+ + HCO3

87
Q

Concentration Equilibrium achieved by

A

HCO3 excess diffusing out of the RBC into the plasma

88
Q

Plasma HCO3 combines with NaCL to form

A

NaCO3

89
Q

Choride shift HCO3 + NaCL ->

A

NaHCO3 + free Cl-

90
Q

CO2 Elimination at the lungs

A

all the chemical reactions at the tissue level reverse and unload the CO2 until the PCO2 is equal

91
Q

Electrolytes

A

electrically charged ions (Na+, K+, Ca++, Mg++, Cl-)

92
Q

Buffers

A

neutralize both acids and bases

93
Q

two most important in buffer system

A

Carbonic acid (H2CO3) and sodium bicarbonate (NaHCO3)

94
Q

Normal HCO3 to H2CO3 ratio is

A

20:1

95
Q

A HCO3 of 24 mEq/L would have a H2Co3 of

A

1.2mEq/L

96
Q

PaCO2-pH relationship

A

based on a norm PaCO2 of 40 mmHg (1.) for every 20mmHg increase (above 40), in the PaCO2, the pH will decrease by 0.10 (2.) for every 10mmHg decrease, in the PaCO2, the pH will increase by 0.10

97
Q

PaCO2-HCO3 relationship

A

(1.) an acute PaCO2 increase of 10mmHg will increase the HCO3 by 1 mmol/L (2.) an acute PaCO2 decrease of 10mmHg will decrease the HCO3 by 2mmol/L

98
Q

Shift in CO2 will affect pH IF

A

bicarbonate stays the same

99
Q

Percent carried by RBC

A

98%

100
Q

Predicting Respiratory pH ex. 76.. greater than 40

A

76-40=36 x 1/2 = 18 or .18, 7.40-.18= 7.22

101
Q

Predicting Respiratory pH ex. 18… less than 40

A

40-18= 22 or .22, 7.40+ .22 = 7.62

102
Q

Respiratory Acidosis=

A

Acute/ Chronic hypoventilation

103
Q

Respiratory alkolosis

A

hyperventilation

Cardiopulmonary A & P (5 decks)

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