Chapter 12: Assessment and Care of Patients with Problems of Acid-Base Balance

Question 1

Body fluid pH

Answer 1

is a measure of the body fluid’s free hydrogen ion level, which has thenarrowest range of normal and the tightest control mechanisms of all electrolytes.

Question 2

The normal pH of the body’s extracellular fluids (including blood)

Answer 2

is 7.35 to 7.45

The body keeps blood pH between 7.35 and 7.45 in a similar manner; however, this valueis not strictly neutral (7.0 is neutral) but, rather, is slightly alkaline.

Question 3

The normal pH of arterial blood is

Answer 3

slightly higher (less acidic) than venous blood.

Question 4

Lower pH values (below 7.35) mean

Answer 4

acidosis is present.

Question 5

Higher pH values (above 7.45) mean

Answer 5

alkalosis is present

Question 6

Acid and Base and Hydrogen

Answer 6

Balance occurs through control of hydrogen ion (H+) production and elimination.

• The more hydrogen ions present, the more acidic the fluid.
• The fewer hydrogen ions present, the more alkaline the fluid.

Question 7

1 pH unit change actually represents

Answer 7

a tenfoldchange in free hydrogen ion level.

Question 8

Abnormal pH interferes with many normal physiologic functions, including the

Answer 8

ofunction of hormones and enzymes.

odistribution of other electrolytes

.oactivity of the heart, nerves, muscles, and GI tract.

oeffectiveness of many drugs.

Question 9

Acids

Answer 9

are substances that release hydrogen ions when dissolved in water (H2O)

Question 10

base

Answer 10

is a substance that binds free hydrogen ions in solution.

Question 11

ACID–BASE BALANCE is regulated by

Answer 11

chemical, respiratory, and kidney actions.

Question 12

The lungs control

Answer 12

the amount of CO2 that is retained or exhaled.

Question 13

The kidneys regulate

Answer 13

the amount of hydrogen and bicarbonate ions that are retained orexcreted by the body.

Question 14

ACID–BASE BALANCE occurs by

Answer 14

matching the rate of hydrogen ion production (which is acontinuous normal process) with hydrogen ion loss.

Question 15

Compensation

Answer 15

is the process in which the body uses its three regulatory mechanisms(chemical, respiratory, and renal) to correct for changes in the pH of body fluids

Question 16

If a lung problem causes retention of carbon dioxide

Answer 16

the healthy kidney compensates by

increasing the amount of bicarbonate that is produced and retained.

Question 17

The best way to determine acid–base balance is to

Answer 17

analyze arterial blood gases (ABGs).

Question 18

Hyperkalemia

Answer 18

occurs with acidosis as hydrogen ions are exchanged with potassium and are pulled inside the cell. Once the patient has been treated for acidosis, the serum potassium levels fall and the patient will require supplementation of potassium.

Question 19

Assess heart rate and rhythm _____ for any patient with an acid–base imbalance.

Answer 19

at least every 2 hours

Question 20

hydrogen ion levels and CO2 levels are directly related to one another

Answer 20

so that an increase in one causes an equal increase in the other.

Question 21

normal ratio of carbonic acid and bicarbonate level in extracellular fluid is

Answer 21

1:20

Question 22

Whenever the CO2 level changes

Answer 22

the pH changes to the same degree in the opposite direction since carbon dioxide is the most changeable component of carbonic acid.

Question 23

Anything that increases the CO2 level in the blood

Answer 23

increases the hydrogen ion content and lowers the pH.