Exam 1 - Acid-Base Balance Flashcards
a substance that releases H ions
acid
a substance that takes up H
base
substances that can react as an acid or as a base
buffers
What is acid-base balance?
Process of regulating pH, HCO3 concentration, and PaCO2
process of resisting changes in pH when acids or bases are added or removed
acid buffering
removal of acids from the body
acid excretion
What are the two key systems in acid-base balance?
Renal, respiratory
Name the 4 main risk factors for acid-base balance
(1) Changes with aging
(2) decreased kidney function
(3) decreased lung elasticity
(4) underlying conditions that impact respiratory and renal function
What is the goal of acid-base balance?
Maintain arterial blood pH of 7.35-7.45
Name the 3 acid-base regulation systems
(1) Buffer system
(2) Respiratory system
(3) Renal system
What is the most powerful regulation system?
Renal
What is the first line of defense for regulation?
Buffer system
What is the primary ECF buffer system?
H2CO3 / HCO3
Respiratory is associated with more _____ conditions than metabolic
neurological s/s
Respiratory acidosis causes
Hypoventilation
Inadequate chest expansion
COPD, pneumonia, Atelectasis
Muscle weakness
Airway obstruction
Narcotics
Respiratory acidosis clinical manifestations
Headache
Decreased LOC
Hypoventilation
Cardiac dysrhythmias
Rapid, shallow respirations
Hyperkalemia
Hypotension
Metabolic acidosis causes
(1) Increased H production
(2) Decreased H elimination
(3) Decreased HCO3 production
(4) Increase HCO3 elimination
(5) Thyroid storm
DKA is associated with ____ ____ d/t _____.
metabolic acidosis; increased H production
Kidney infection is associated with _____ ____ d/t ______
metabolic acidosis; decreased H elimination
Dehydration and liver failure are both associated with which imbalance d/t what?
Metabolic acidosis; decreased HCO3 production
Diarrhea and GI drains are associated with which imbalance? d/t what?
metabolic acidosis; increase HCO3 elimination
Metabolic acidosis clinical manifestations
Headache, confusion
Decreased muscle tone and reflexes
Warm, flushed skin
N/V
Kussmaul respiration
Hyperkalemia
Deep, labored, and rapid breathing pattern
Kussmaul Respiration
Respiratory alkalosis causes
Hyperventilation
Fear, acute pain, anxiety
CNS disorders
Mechanical ventilation
Metabolic acidosis
Respiratory alkalosis clinical manifestations
Hyperventilation
Tachycardia
Lightheadedness
N/V
N/T of extremities
Hypokalemia
Seizures
Metabolic Alkalosis causes
(1) Gain of HCO3
(2) Loss of H
What can lead to a gain of HCO3, and ultimately metabolic alkalosis?
(1) Diuretics
(2) Antacids
(3) Massive blood transfusion
What can lead to a loss of H, and ultimately metabolic alkalosis?
(1) Prolonged vomiting
(2) Gastric suctioning
Metabolic alkalosis clinical manifestations
Hypoventilation
Confusion
Dizziness
NVD
Hypokalemia
____ can more easily cross the blood-brain barrier, compared to ____
CO2; HCO3
What is the most common cause of metabolic acidosis?
DKA
Clinical management of Acid-Base balance disorders include prevention, such as…
(1) smoking cessation
(2) sufficient oral intake
Collaborative interventions for acid-base balance disorders include…
(1) respiratory support
(2) F&E support
(3) safety and support
The most important part of nursing intervention for acid-base disorders is what?
Assessment! Monitoring for complications, effectiveness of Tx, symptoms, underlying cause, etc.
One piece of nursing education that nurses can provide is what?
Management of chronic underlying conditions
