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Path Exam 1 > Exam 1 Acid|Base/ Fluid & Electrolytes > Flashcards

Exam 1 Acid|Base/ Fluid & Electrolytes Flashcards

1
Q

What is a(n):
Acid
Base

A

Donates Hydrogen Ions H+ in solution
Accepts H+
Low pH=Acidic
Normal pH 7.35-7.45

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2
Q

What does Cellular Metabolism yield?

“elements”

A

CO2, Lactic Acid

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3
Q

What organs regulate Acid and bases

A

Lungs

Kidney

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4
Q

This organ works faster but less effective than which organ?

And vice versa

A

Lungs fast low effective than Kidney

Kidney slow but more effective

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5
Q

How do lungs regulate A/B

A

Controlling the release of CO2

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6
Q

How does the kidneys regulate A/B

A

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

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7
Q

Acid- base Correction

A

Values for both components of the buffer return to normal level

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8
Q

Which organ decreases carbonic acid by excreting CO2

A

Lungs

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9
Q

Which organ Reabsorbs bicarbonate or regenerate new bicarbonate from CO2 and H2O

A

Kidneys

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10
Q

What is compensation? Give example.

A

If the problem is the lungs retaining CO2 the kidney retains HCO (bicarbonate)
If the problem is the kidney the lungs will help

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11
Q 
What are the normal pH values of 
Blood:
PaCO2
PaO2
HCO3
A

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

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12
Q

What is Respiratory Acidosis
What would the pH be?
Which organ causes this problem?
What is the PaCO2?

A

↑ CO2 in blood (hypercapnia) cant eliminate from body
CO2+H2O=H2CO3
pH <7.35
PaCO2 >45mmHg

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13
Q

Respiration Vs Ventilation

A

Gas exchange between atmosphere and blood(cells)

Movement of air in and out of airway

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14
Q

Respiratory acidosis etiology?
What is an illness Caused by Respiratory acidosis
What is S/S

A

Condition affects alveolar ventilation resulting in ↑ CO2

COPD; Pneumonia (can cause rapid breaths), Drug overdose, anesthetic

Headache, blurred vision, “lessness”

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15
Q

What organ compensates for Respiratory Acidosis and how?
HCO3
Tx:

A

Kidney ↑HCO3 reabsorption and ↑H+ excretion
thus, ↑HCO3 level is >26
O2 and Bronchodilators

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16
Q 
What is Respiratory Alkalosis? 
What is the pH?
PaCO2?
Blood level?
Main cause of Respiratory Alkalosis
A

↓CO2 in blood is hypocapnia
>7.45
<35
Hyperventilation, High altitude, severe anxiety, hypoxemia (Low O2 in blood), fever

17
Q

What organ compensates for Respiratory Alkalosis and how?
Respiratory Alkalosis etiology
S/S of Respiratory Alkalosis?
Tx:

A

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

18
Q 
What is Metabolic Acidosis?
Which organ is affected?
What does the compensatory organ do? 
S/S
Tx
pH
HCO3 ?
PaCO2
A

↑ 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

19
Q 
What is Metabolic Alkalosis?
Causes?
S/S
What does the compensatory organ do? 
Tx
A

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

20
Q

Hydrostatic pressure(HP)
Osmotic pressure
Oncotic pressure/Colloidal

A

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)

21
Q

Osmolality

Osmolarity

A

Measurement of concentration of solutes normal range 282-295
>295=dehydration, <282=water retention

22
Q

Tonicity
Isotonic:
Hypotonic:
Hypertonic:

A

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

23
Q

Explain the RAAS system

A

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

24
Q

Natriuretic Peptides: ANP; BNP; CNP

A

• 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

25
Q

What is Edema?
Cause
Dependent Edema?***

A 
Excess fluid in ISF
• Increased Hydrostatic pressure, 
Venous obstruction, prolonged sitting 
• Decreased plasma oncotic pressure
Malnutrition 
• Liver disease 
nephrotic syndrome : protein in urine/ Kidney cant conserve protein 
common in people with CHF
Sitting down= legs/ bed bound =the back*** certain area of the edema b/c prolonged immobility
26
Q

Dehydration

S/S

A

Lack of ADH
Dark urine
burns, diarrhea
Diabetes insipidus, weight loss

27
Q

Hypernatremia
S/S
Tx

A 
Occurs when serum Na is above 145 mEq/L
• Normal: 135- 145 mEq/
 Over secretion of Aldosterone
intracellular dehydration
HTN, weight gain, Affects CNS, 
Isotonic salt free IV fluids
28
Q

what is Aldosterone

A

Na retention, K excretion

29
Q

Hyponatremia
S/S
Tx

A

Na level= below 135 mEq/L
water intoxication, vomiting, diarrhea, diuretics
Neuro changes- lethargy , dizziness
Hypertonic Saline, restrict water intake

30
Q

Potassium (K) Levels
What organ regulates K?
What (2) factors affect K level?

A

Normal: 3.5- 5.0 mEq/L • Hyper= K > 5.0 (or 5.2, or 5.5)
Kidney
Aldosterone and Insulin
Insulin not only brings glucose to cells but increases permeability of cell to K to lower K from being in the blood stream

31
Q

What is Hyperkalemia?
What is the level?
S/S
Tx

A

K > 5.0 (or 5.2, or 5.5)
Rare, Increase K in blood stream
blood hemolysis and burns causes K to go into the blood stream, ACE inhibitors
Renal failure - body not able to excrete K

Irregular PR and cardiac arrest

kayexalate - captures K to poop out K

32
Q

What is Hypokalemia?
what is the level?
S/S
Tx

A

Low K
<3.5
Caused by diuretic therapy, inadequate intake- NPO, alcoholics, eating disorders
Anorexia, leg cramps, muscle fatigue

need K supplement

Path Exam 1 (7 decks)

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