Exam 2 Acid/Base

Question 1

ABG measures?

Answer 1

pO2
O2 sat
pH
pCO2
HCO3

Question 2

Normal range:

pO2
O2 sat
pH
pCO2
HCO3

Answer 2

pO2 = 80 - 100

O2 sat > 95%

pH = 7.35 - 7.45

pCO2 = 35 - 45

HCO3 = 22 - 26

Question 3

Acidemia value?

Answer 3

pH < 7.35

Question 4

Alkalemia value?

Answer 4

pH >7.45

Question 5

Respiratory Acidosis value?

Answer 5

pCO2 > 45 (if primary process)

Question 6

Respiratory Alkalosis value?

Answer 6

pCO2 < 35 (if primary process)

Question 7

Metabolic Acidosis value?

Answer 7

HCO3 < 22 (if primary process)

Question 8

Metabolic Alkalosis value?

Answer 8

HCO3 > 26 (if primary process)

Question 9

Critical values:

pH

pCO2

HCO3

pO2

O2 sat

Answer 9

pH < 7.25 or > 7.55

pCO2 < 20 or > 60

HCO3 < 15 or > 40

pO2 < 60

O2 sat < 75%

Question 10

Respiratory Acidosis from?

Respiratory Alkalosis from?

Answer 10

hypovent

hypervent

Question 11

Metabolic Acidosis from?

Metabolic Alkalosis from?

Answer 11

low bicarb

high bicarb

Question 12

Metabolic compensation lead time?

Answer 12

3-5 days

Question 13

Primary abnormality determined how?

Answer 13

Look at shift in pH ->
whatever process caused it will be one the same side

e.g. if pH is acidic, pCO2 will also be acidic if it is the cause

Question 14

Anion Gap calculated how?

Normal is?

Answer 14

[Na+] - [Cl + CO2]

8 - 12

Question 15

Anion Gap of >= 20 tells us?

Answer 15

There is primary metabolic acidosis regardless of pH or HCO3

Body doesn’t make large ion gap to compensate for chronic alk disorder

Question 16

Acute conditions present how?

Answer 16

w/o metabolic compensation

Question 17

Acute Resp Acidosis caused by? (4)

Answer 17

Airway obstruction
PNA/PE/Thorax
CNS depression
Neuro/mm disorders

Question 18

Chronic Resp Acidosis caused by? (3)

Answer 18

Obstructive or restrictive lung dz
Chronic neuro/mm dz
Chronic resp despression

Question 19

Respiratory Alkalosis caused by?

Answer 19

Hypervent
Anxiety/pain
Hypoxemia
Sepsis
Preggos
PNA/PE
Hepatic dz
CHF

Question 20

Metabolic Acidosis w/ gap > 12 caused by? (4)

Answer 20

KNOW THIS SLIDE
Ketoacidosis (DM, etoh, starvation)
Lactic acidosis
Renal fail
Toxins (salicylates, methanol, eth glycol, paraldehyde)

Question 21

Metabolic Acidosis w/ gap <=12 caused by? (2 main sources)

Answer 21

GI bicarb loss:
Diarr, fistulas

Renal bicarb loss:
fail, tube acidosis
carbonic inhib (Diamox)
aldosterone inhib (spironolcatone)

Question 22

Metabolic Alkalosis caused by? (4)

Answer 22

Vomiting (loss of acid)
Diuretics
Antacids
High Mineralcorts

Question 23

Conditions you can not have together?

Answer 23

Respiratory acidosis and resp alkalosis

Question 24

Conditions you can have together?

Answer 24

Metab acid/alk

Resp acid or alk w/ either metabolic

Question 25

Mixed Acid-Base disorder determined how?

Answer 25

Compensation response will be outside normal range (e.g. HCO3 > 26) ->
means there are two primary disorders

Question 26

If Mixed Acid-Base suspected, then what?

Answer 26

Assuming comp is outside normal range:

1) If gap ≥ 20, Primary Metabolic Acidosis regardless of pH/bicarb levels
2) (Gap - 12) + HCO3:
If > 26, Metabolic Alkalosis regardless of pH/bicarb