Chapter 9 Altered Acid Base Balance Flashcards
Acid-base balance
regulated to maintain normal pH
Acids
donate hydrogen ions
Bases
accept hydrogen ions
pH
clinical measurement of the acid-base ratio
Anion Gap
measures the major cations and anions in the plasma, providing an indication of acid-base balance
Buffering systems
Plasma buffer: bicarbonate, protein, potassium-hydrogen-exchange
Respiratory buffer (expelling of CO2
Renal: H+ ion and HCO3, tubular, k+ and H+ exchange, CI and HCO3
Plasma buffer
reacts within seconds in response to hydrogen ion concentration
Respiratory buffer system
reacts within minutes to excrete CO2 through change in respiratory rate
Renal buffer system
reacts within hours to days through the production, absorption, and excretion of acids, bases, and ions
Bicarbonate buffer system
substitutes strong acid HCL for weaker acid H2CO3 and strong base NaOH is substituted for the weak base NaHCO3
Protein Buffer System
largest buffer system, albumin and plasma globulins, can accept and give H+ ions
Potassium Hydrogen
Hydrogen enters the cell and potassium escapes to extracellular compartment
Renal Buffer Systems
hydrogen ion elimination/bicarbonate conservation tubular, potassium-hydrogen exchange, chloride-bicarbonate exchange
Acidosis
systemic decrease in H+ concentration or increase in bicarbonate
Alkalosis
systemic increase in H+ concentration or decrease in bicarbonate
Normal blood pH
7.35 to 7.45
PCO3 (partial carbon dioxide)
35-45 mmHg
HCO3 (bicarbonate)
22-26 mEg/L
Metabolic Acidosis
buildup of acid in the body due to some sort of renal failure; bicarbonate levels are affected
Metabolic alkalosis
buildup of basic ions, too much bicarbonate in the blood
Respiratory acidosis
when your lungs cannot remove enough CO2 from the body
Respiratory alkalosis
caused by hyperventilation, getting rid of too much CO2
Highly active antiretroviral therapy (HAART) - associated acidosis
used to treat HIV, mitochondrial dysfunction, hyperlactatemia/lactic acidemia, lactic acidosis, vomiting, nausea, weight loss
Diagnosed by clinical manifestations, blood lactate levels, electrolyte and blood pH levels, liver function tests
- Which of the following is an example of a strong acid?
a. Albumin
b. Inorganic phosphorus
c. Sodium
d. Lactate
Lactate
- An anion gap of 16 can be calculated by which of the following scenarios?
a. Sodium 146, chloride 102, bicarbonate 26 mEq/L
b. Sodium 140, chloride 102, bicarbonate 26 mEq/L
c. Sodium 136, chloride 122, bicarbonate 30 mEq/L
d. Sodium 148, chloride 100, bicarbonate 28 mEq/L
Sodium 146, chloride 102, bicarbonate 26 mEq/L
- A pH of 7.5 is defined as:
a. alkalosis.
b. acidosis.
c. acidemia.
d. alkalemia.
alkalosis
- An example of anion exchange includes:
a. sodium and hydrogen exchange.
b. sodium and chloride exchange.
c. bicarbonate and chloride exchange.
d. hydrogen and bicarbonate exchange.
bicarbonate and chloride exchange.
- Hypokalemia is often associated with which one of the following conditions?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Hyperchloremia
d. None of the above
a. Metabolic alkalosis
- Metabolic acidosis may be associated with:
a. increased chloride levels.
b. increased metabolic acids.
c. decreased bicarbonate.
d. all of the above.
all of the above.
- Hyperlactatemia due to drug treatment is a complication in which of the following conditions?
a. Salt-losing tubulopathy
b. Cirrhosis
c. AIDS
d. Isonatremic dehydration
AIDS
Hydrogen ion concentration
the inverse of the pH, when pH is low, there is high amount of H+ and when pH is high, there is a low amount of H+
