Chapter 54 - Traditional acid base analysis Flashcards
What are representations of the metabolic contribution to acid-base balance?
bicarbonate, base excess, TCO2
What’s the role of anion gap in acid base analysis?
identify the cause of a metabolic acidosis
What sodium bicarbonate therapy is indicated?
1) treatment with metabolic acidosis associated with kidney disease
2) diarrhea associated loss of bciarbonate
What are three major processes to maintain acid-base balance?
1) reuglation of PCO2 by alveolar ventilation
2) buffering of acids by bicarbonate and nonbicarbonate buffer system
3) changes in renal excretion of acid or base
True or false: bicarbonate is not independent of changes in PCO2
elevation of PCO2 will lead to elevations of bicarbonate
decrease in PCO2 will lead to a decrease in bicarbonate
What is major advantage of using BE over bicarbonate concentration?
It is independent of changes in the respiratory system
Two common mechanisms of metabolic acidosis
1) loss of bicarbonate vis GI or kidney: hyperchloremic metabolic acidosis, no change in AG
2) gain of acid, increased anion gap
True/false: hypoalbuminemia can mask the presence of unmeasured anions
True: abnormal unmeasured anions may be present but the calculated anion gap may still remain wihtin the reported reference range. AG is not reliable in hypoalbuminemic patient
T/F: metabolic compensatory response to a primary respiratory disorder takes hours to begin and 2-4 days to complete
True
T/F: bicarbonate therapy is contraindicated in patients with a respiratory acidosis
True
Differentials of respiratory alkalosis
disease that stimulate an increased RR and TV (significant hypoxemia, pulmonary parenchymal disease, airway inflammation), central stimulation of respiratory center (brain injury, behavior-pain or anxiety)
