Exam 1 Acid|Base/ Fluid & Electrolytes Flashcards
What is a(n):
Acid
Base
Donates Hydrogen Ions H+ in solution
Accepts H+
Low pH=Acidic
Normal pH 7.35-7.45
What does Cellular Metabolism yield?
“elements”
CO2, Lactic Acid
What organs regulate Acid and bases
Lungs
Kidney
This organ works faster but less effective than which organ?
And vice versa
Lungs fast low effective than Kidney
Kidney slow but more effective
How do lungs regulate A/B
Controlling the release of CO2
How does the kidneys regulate A/B
Retaining or excreting H+ and Bicarbonate
ex. Body becomes Basic conserve H+ and and excrete bicarbonate or body acidic excrete H+ and and conserve bicarbonate
Acid- base Correction
Values for both components of the buffer return to normal level
Which organ decreases carbonic acid by excreting CO2
Lungs
Which organ Reabsorbs bicarbonate or regenerate new bicarbonate from CO2 and H2O
Kidneys
What is compensation? Give example.
If the problem is the lungs retaining CO2 the kidney retains HCO (bicarbonate)
If the problem is the kidney the lungs will help
What are the normal pH values of Blood: PaCO2 PaO2 HCO3
Blood: 7.35-7.45
PaCO2: 35-45mmHg
PaO2: 90-100mmHg
HCO3: 22-26
Not from veins but from ABG (arterial blood gas) this is being taken from the arteries
What is Respiratory Acidosis
What would the pH be?
Which organ causes this problem?
What is the PaCO2?
↑ CO2 in blood (hypercapnia) cant eliminate from body
CO2+H2O=H2CO3
pH <7.35
PaCO2 >45mmHg
Respiration Vs Ventilation
Gas exchange between atmosphere and blood(cells)
Movement of air in and out of airway
Respiratory acidosis etiology?
What is an illness Caused by Respiratory acidosis
What is S/S
Condition affects alveolar ventilation resulting in ↑ CO2
COPD; Pneumonia (can cause rapid breaths), Drug overdose, anesthetic
Headache, blurred vision, “lessness”
What organ compensates for Respiratory Acidosis and how?
HCO3
Tx:
Kidney ↑HCO3 reabsorption and ↑H+ excretion
thus, ↑HCO3 level is >26
O2 and Bronchodilators
What is Respiratory Alkalosis? What is the pH? PaCO2? Blood level? Main cause of Respiratory Alkalosis
↓CO2 in blood is hypocapnia
>7.45
<35
Hyperventilation, High altitude, severe anxiety, hypoxemia (Low O2 in blood), fever
What organ compensates for Respiratory Alkalosis and how?
Respiratory Alkalosis etiology
S/S of Respiratory Alkalosis?
Tx:
Kidney: ↓H+ excretion, ↑H+ reabsorption and ↓HCO reabsorption (↑HCO excretion)
anything that causes hyperventilation i.e hypoxemia, hypermetabolic state
Dizziness, confusion, coma
pain management, breathe in paper bag, try to ↑CO2
What is Metabolic Acidosis? Which organ is affected? What does the compensatory organ do? S/S Tx pH HCO3 ? PaCO2
↑ non-carbonic acids/ loss of HCO3
Ketoacidosis (Starvation) lactic acidosis (shock)
Lungs: excess H+ stimulates the respiratory center to increase rate
Tachycardia, deep rapid breathing, diarrhea
Sodium bicarbonate, tx diabetic
pH <7.35
HCO3 <22
PaCO2 can be normal
What is Metabolic Alkalosis? Causes? S/S What does the compensatory organ do? Tx
Loss of acids —> ↑HCO
Caused by too much HCO3 ingestion, Cushings syndrome hyperaldosteronism, loss of gastric fluid, diuretics
Seizures and dizziness, confusion
Lungs: breathing becomes slower, lungs will try to conserve CO2 to create carbonic acid
Electrolyte/fluid replacement
Hydrostatic pressure(HP)
Osmotic pressure
Oncotic pressure/Colloidal
Force from water in capillaries causes water to move to interstitial space. Give IV fluids to increase HP
Exerted by solutes in solution. Pulls water from ICF and ISF into blood stream
Force exerted by albumin(protein) in the blood stream- keeps water in the blood stream
Pressure 3.1-4.3g/dl (edema fluid outside the blood vessels)
Osmolality
Osmolarity
Measurement of concentration of solutes normal range 282-295
>295=dehydration, <282=water retention
Tonicity
Isotonic:
Hypotonic:
Hypertonic:
amount of solute in the solution (bloodstream)
plasma expanders normal saline solution
less solutes than in the blood stream, half normal saline
more solutes, for people with low sodium level
Explain the RAAS system
Decreased blood volume - > a) stimulates the thirst center in hypothalamus -> person feels thirsty -> (drink water)
b) decreased amount of blood going to the kidney - > 1)attempts
to conserve by decreasing amount of urine to be produced;
2) kidney secretes Renin - > this enzyme stimulates liver - > to
produce Angiotensinogen - > angiotensinogen travels to lungs - > Angiotensinogen converted to Angiotensin 1 - > converted to Angiotensin II by angiotensin-converting enzyme (ACE) - > Angiotensin II stimulates Adrenal gland to secrete Aldosterone Aldosterone- causes sodium and water reabsorption into the bloodstream - > blood volume increases
Angiotensin II Increases BP and does Vaso constriction
Natriuretic Peptides: ANP; BNP; CNP
• ANP- produced by cardiac atria
• CNP- produced by endothelial cells of arteries and ventricular cells of the
heart • BNP- produced by heart ventricles and to lesser extent, by the brain cells. • BNP is secreted in response to fluid overload that can stretch the heart’s
ventricles (especially the left ventricle).
• Note: you will meet this term again and again in Cardiac/cardiology and if you work in
Cardiac unit! • Increased blood volume- > increased ventricular muscle stretching- > more BNP
produced!
Elevated BND-fluid retention
