Exam 2

Question 1

The process of regulating the pH, bicarbonate concentration, and partial pressure of carbon dioxide of body fluids.

Answer 1

acid-base balance

Question 2

What are the three major buffering systems?

Answer 2

chemical buffers, the lungs, and the kidneys

Question 3

These work in a manner of seconds to buffer and neutralize acids. Bicarbonate and carbonic acid is an example.

Answer 3

chemical buffers

Question 4

These work as a buffer by controlling carbon dioxide and carbonic acid through adjusting ventilation. In metabolic acidosis they work faster to eliminate CO2, and in metabolic alkalosis they work slower to retain CO2.

Answer 4

the lungs

Question 5

These buffer by excreting acids or retaining H+ ions. They control HCO3 which is a base. They may take days in order to buffer effectively.

Answer 5

the kidneys

Question 6

Increased hydrogen concentration decreased bicarbonates.

Answer 6

acidosis

Question 7

Decreased hydrogen concentration or increased bicarbonates.

Answer 7

alkalosis

Question 8

This condition could be caused by diabetic ketoacidosis, lactic acidosis due to shock and increased exercise, renal tubular acidosis, renal failure or GI fistulas. There could also be the presence of excess acid from aspirin or alcohol, or a loss of bicarbonates such as during prolonged vomiting and severe diarrhea. Clinical manifestations include headaches, Kussmaul’s respirations, hypercalcemia, and cardiac arrythmias due to hyperkalemia.

Answer 8

metabolic acidosis

Question 9

This can be caused by severe vomiting, excess gastric suctioning, diuretic therapy, potassium deficit, excess NaHCO3 intake, excessive mineralocorticoids. Clinical manifestations include confusion, seizures, dizziness, numbness and tingling with low calcium, potassium deficit, shallow and slow respirations, muscle cramps, emesis, dysrhythmias, nausea, hypertonic muscles.

Answer 9

metabolic alkalosis

Question 10

This can be caused pulmonary embolism, atelectasis, pneumothorax, overdose on sedatives, sleep apnea, pneumonia muscular dystrophy, Guillain-Barre, chest wall abnormalilty (obesity), adult respiratory distress syndrome, myasthenia gravis, respiratory failure. Clinical manifestations include dyspnea, disorientation, dysrhythmias, tachycardia, dizziness, headaches, warm flushed skin, hyperkalemia, hypercalcemia.

Answer 10

respiratory acidosis

Question 11

This can be caused by regular or mechanical hyperventilation, excessive CO2 excretion caused by hypoxia, anxiety, fear, increased exercise, pain, overstimulation of the respiratory center such as in septicemia, encephalitis, or brain injuries. Clinical manifestations include hypokalemia, nausea, vasoconstriction of cerebral blood vessels causes dizziness and faintness. Decreased calcium ionization causes spasms of fingers and hands.

Answer 11

respiratory alkalosis

Question 12

What treatment options are available for metabolic acidosis?

Answer 12

Treat the underlying condition. Sodium bicarbonate can be given IV, fluid and electrolyte replacement, isotonic IV solutions, insulin if diabetes is the cause, treat hypercalcemia if needed.

Question 13

What treatment options are available for metabolic alkalosis?

Answer 13

Treat the underlying condition. Treat hypocalcemia is needed, fluid and electrolyte replacement, watch for hypokalemia as treatment progresses.

Question 14

What treatment options are available for respiratory acidosis?

Answer 14

Improve respiratory function. Correct hyperkalemia, watch for tetani, watch for CO2 narcosis from giving oxygen.

Question 15

What are some treatment options for respiratory alkalosis?

Answer 15

Treat the underlying causes. Breathe into a paper bag to bring in CO2, which combines with water to make HCO3 which buffers alkalosis. Also a sedative can be given.

Question 16

What is the normal pH level of blood?

Answer 16

7.35-7.45

Question 17

What is the normal range for arterial pCO2 in the blood?

Answer 17

35-45 mmHg

Question 18

What is the normal range for arterial pO2 in the blood?

Answer 18

80-100 mmHg

Question 19

What is the normal range for arterial HCO3?

Answer 19

22-26 mEq/L

Question 20

What does the acronym ROME stand for?

Answer 20

Respiratory Opposite, Metabolic Equal

Question 21

If pH is abnormal and pCO2 goes in the opposite direction it’s what kind of problem?

Answer 21

respiratory

Question 22

If pH is abnormal and HCO3 goes in the same direction, it’s what kind of problem?

Answer 22

metabolic

Question 23

In uncompensated conditions the pH….

Answer 23

…is always abnormal.

Question 24

In uncompensated respiratory conditions, pCO2 is _________, and HCO3 is ________.

Answer 24

abnormal, normal

Question 25

In uncompensated metabolic conditions, pCO2 is _________, and HCO3 is _________.

Answer 25

normal, abnormal

Question 26

In partial compensation, pH, pCO2, and HCO3 are all what?

Answer 26

abnormal

Question 27

In full compensation, pH is _________, and pCO2 and HCO3 are _________.

Answer 27

normal, abnormal

Question 28

The process of regulating the extracellular fluid volume, body fluid volume, body fluid osmolality, and plasma concentrations of electrolytes.

Answer 28

fluid and electrolyte imbalance

Question 29

Volume problems affect what organ the most?

Answer 29

the heart

Question 30

This fluid imbalance can be caused by abnormal loss of body fluids, decreased intake, or plasma to interstitial fluid shift, or inadequate fluid intake. This is accompanied by the loss of one or more electrolytes usually sodium. Clinical manifestations include restlessness, lethargy, confusion, thirst, increased pulse, dry mouth, postural hypotension, decreased urine output, weakness, dizziness, weight loss, dry mucus membranes, and increased respirations.

Answer 30

ECF or Isotonic Volume Deficit (Hypovolemia or Dehydration)

Question 31

This fluid imbalance can be caused from increased intake of fluids, abnormal retention of fluids (HF & renal failure) or interstitial to plasma fluid shift, SIADH. Clinical manifestations include peripheral edema, distended neck veins, dyspnea, crackles, weight gain, increased blood pressure and urine output.

Answer 31

ECF or Isotonic Volume Excess (Hypervolemia)