Exam 2 - Acid Base Balance Flashcards
acidemia
arterial blood pH < 7.35
acidosis
process that adds acid or eliminates base from body
alkalemia
arterial blood pH > 7.45
normal ratio of base to acid
20:1
acid-base regulatory mechanisms
buffer system
respiratory system
renal system
how soon does the buffer system work?
on the scene in seconds
how soon does the respiratory system work?
within minutes to retain or eliminate CO2
how soon does the renal system work?
starts in hours, more permanent
takes up to 5 days to complete
when you become acidotic, which electrolyte will switch with H+
K
will have hyperkalemia s/sx
when you become alklalotic, you will be in which electrolyte imbalance?
hypokalemic
no movement in the body to compensate for imbalance
uncompensated
little movement in the body to compensate for imbalance
partially
cause of respiratory acidosis
hypoventilation
COPD, PNA, atelectasis, chest wall abn, sedative/narcotic OD, resp. muscle weakness, injury to resp. center, underventilation
s/sx of respiratory acidosis
slow, shallow or rapid, shallow respirations HA seizures AMS decreased LOC hypotension dysrhythmias weak, thready pulse tachycardia warm, flushed skin
what do the kidneys do to compensate respiratory acidosis
eliminate H+ and retain HCO3
respiratory acidosis managment and assessment
respiratory, cardio assessment assess LOC monitor ABG, electrolytes adequate fluids O2 mechanical ventilation frequent oral hygiene safety measure assess skin, nail beds, mucus membranes elevate HOB, tripod
CORRECT CAUSE, IMPROVE VENTILATION
possible meds for respiratory acidosis
bronchodilators
abx
mucomyst
anticoag
what can cause respiratory alkalosis
hyperventilation anxiety attacks ASA posioning septicemia PE
*rare
s/sx of respiratory alkalosis
dyspnea chest tightness lightheadedness dizziness anxiety, panic tetany, convulsions blurred vision myocardial irritability increased HR
respiratory alkalosis compensation
kidneys conserve H+
respiratory alkalosis assessment and management
TREAT CAUSE resp., cardio. assessment breathe slower rebreathe CO2 O2 if hypoxic antianxiety meds support, reassure protect from injury teach relaxation techniques, stress management keep ASA out of reach of children
metabolic acidosis compensation
lungs eliminate CO2
cause of metabolic acidosis
DKA lactic acidosis starvation severe diarrhea renal failure GI fistula shock
*anything coming out of the lower GI tract will put a pt in acidosis
s/sx metabolic acidosis
HA low BP hyperkalemia muscle twitching warm, flushed skin N/V low muscle tone confusion, drowsiness Kussmaul respirations coma
metabolic acidosis treatment
TREAT THE CAUSE administer bicarb monitor K levels tx hypocalemia monitor labs I&O, daily weight assess VS, LOC, GI function rehydrate administer NS, regular insulin, K if DKA, antidiarrheal protect from injury
metabolic alkalosis compensation
lungs retain CO2
cause of metabolic alkalosis
severe vomiting excessive NGT suctioning diuretic therapy hypokalemia licorice excessive mineralcorticosteriod
*anything coming out of the mouth will be alkalosis
s/sx of metaboli alkalosis
decreased RR, depth dizziness irritable, nervous, confused tremors, muscle cramps, tetany, hyperreflexia paresthesia seizures tachycardia, dysrhythmias hypotension
assessment, management of metabolic alkalosis
TREAT CAUSE assess LOC, VS, I&O, ABGs, EKG, electrolytes rehydrate protect from injury NS, potassium teach: proper use of antiacids
normal pH value
7.35-7.45
normal CO2 value
35-45
normal bicarb value
22-26
ROME
respiratory
opposite
metabolic
equal
CO2 will be opposite direction of pH; H+ will be going the same direction as pH
