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Pathophysiology > Exam 2: chapter 5 (Acid-Base) > Flashcards

Exam 2: chapter 5 (Acid-Base) Flashcards

1
Q

How does the chemical system regulate pH?

A. uses bicarbonate, hemoglobin, phosphate, and plasma proteins to instantaneously contribute to acid-based corrections (per chemical reactions)
B. compensates by increasing ventilation to expire carbon dioxide or by decreasing ventilation to retain carbon dioxide- control CO2
C. compensates by producing acidic or alkaline urine

A

A. uses bicarbonate, hemoglobin, phosphate, and plasma proteins to instantaneously contribute to acid-based corrections (per chemical reactions)

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2
Q

How does the respiratory system regulate pH?

A. uses bicarbonate, hemoglobin, phosphate, and plasma proteins to instantaneously contribute to acid-based corrections (per chemical reactions)
B. compensates by increasing ventilation to expire carbon dioxide or by decreasing ventilation to retain carbon dioxide- control CO2
C. compensates by producing acidic or alkaline urine

A

B. compensates by increasing ventilation to expire carbon dioxide or by decreasing ventilation to retain carbon dioxide- control CO2

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3
Q

How does the renal system regulate pH?

A. uses bicarbonate, hemoglobin, phosphate, and plasma proteins to instantaneously contribute to acid-based corrections (per chemical reactions)
B. compensates by increasing ventilation to expire carbon dioxide or by decreasing ventilation to retain carbon dioxide- control CO2
C. compensates by producing acidic or alkaline urine

A

C. compensates by producing acid or alkaline urine

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4
Q

Define respiratory acidosis

A

Alveolar Hypoventilation
* Results Hypercapnia
o Increases CO2
 Alveoli not exchanging –> hypoperfusion
 Ventilation (ability to breath –> hypoventilation
* pH < 7.35; PaCO2> 45 mmHg

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5
Q

What are some causes of respiratory acidosis?

A

*Respiratory center (related to CNS) depression(ventilation-related) (head trauma, drugs)
*Respiratory muscle paralysis(ventilation) (rib fractures, DMD)
*Disorders of lung parenchyma (asthma, pneumonia, emphysema, chronic bronchitis)- CO2 not removed appropriately

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6
Q

What are some clinical manifestations of respiratory acidosis?

A

headache, blurred vision, breathlessness, restlessness, progressing to disorientation, convulsions, coma - neurological effects

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7
Q

during respiratory acidosis, how does the body compensate?

A

 Kidneys compensate by eliminating H ions and retaining HCO3

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8
Q

Define respiratory alkalosis

A

o Alveolar Hyperventilation (deep, rapid respirations)
Results in Hypocapnia (decreased PaCO2)
pH > 7.45; PaCO2< 35 mmHg
o Acute or chronic

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9
Q

What are some causes of respiratory alkalosis?

A

o Causes: HYPERVENTILATION!
Hypoxemia (brain injury, pulmenary disease, CHF, altitude)
Hypermetabolic states (fever)
Anxiety/hysteria
Meds/chemicals that increase the RR - stimulants

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10
Q

what are some clinical manifestations of respiratory alkalosis?

A

 Dizziness, confusion, syncope, convulsions, coma - neuro, not enough

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11
Q

during respiratory alkalosis, how does the body compensate?

A

Kidneys compensate by conserving H ions and eliminating HCO3 –> balance

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12
Q

define Metabolic acidosis

A

an accumulation of acid in the body

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13
Q

list some causes of metabolic acidosis

A

○ Ketoacidosis: too much acid
○ Lactic acid accumulation (shock, hypoxemia)
○ Severe diarrhea: losing bicarb
○ Kidney disease
○ Ingestions (aspirin, antifreeze)

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14
Q

list some clinical manifestations of metabolic acidosis

A

Changes in function of the neurologic, respiratory, GI and CV system

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15
Q

how does the body compensate for metabolic acidosis?

A
  • Buffering systems/Lungs compensate blowing off CO2
    -Hyperventilation (lungs not the issue)/Kussmaul respirations
  • kidneys conserve HCO3 and eliminate H+ ions in acidic urine
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16
Q

Define metabolic alkalosis

A

the body’s pH is elevated to more than 7.45
o Base bicarbonate excess or loss of acid

17
Q

what are some causes of metabolic alkalosis?

A

○ Prolonged vomiting or gastric acid suction - increase base
○ Gain of HCO3
○ Diuretics (promote excretion of Na+, K+ and Cl-, not as much HCO3)

18
Q

list clinical manifestations of metabolic alkalosis

A

○ Weakness, muscle cramps, hyperactive reflexes, tetany, confusion, convulsions
○ Increases the binding of calcium to plasma proteins, causing hypocalcemia

19
Q

How does the body compensate during metabolic alkalosis?

A

Lungs compensate partially by retaining CO2 (decreasing respiratory rate) - decreasing RR

Kidneys conserve H+ ions and eliminate HCO3 in alkaline urine

20
Q

Interpret this ABG:

  • pH 7.32
  • PaCO2 67 mm Hg
  • HCO3 25 mEq/L
  • PaO2 47 mm Hg
    What is this acid/base alteration?
A

respiratory acidosis with hypoxemia

21
Q

Interpret this ABG:

  • pH 7.18
  • PaCO2 38 mm Hg
  • PaO2 70 mm Hg
  • HCO3 15 mEq/L
    What is this acid/base alteration?
A

Metabolic acidosis with hypoxemia

22
Q

Interpret this ABG:

  • pH 7.60
  • PaCO2 30 mm Hg
  • PaO2 60 mm Hg
  • HCO3- 22 mEq/L
    What is this acid/base alteration?
A

respiratory alkalosis with hypoxemia

23
Q

Natriuretic peptides are hormones primarily produced by the __________.

A. pituitary gland
B. myocardium
C. kidneys
D. hypothalamus

A

B. myocardium

24
Q

______________, located in the hypothalamus, are stimulated to produce thirst when increased osmolality occurs.

A. Renin
B. Natriuretic peptides
C. Hormones
D. Osmoreceptors

A

D. Osmoreceptors

25
Q

Baroreceptors are nerve endings that are sensitive to changes in ____________. (Select all that apply)

A. high sodium levels
B. blood volume
C. blood pH
D. blood pressure

A

A. high sodium levels
B. blood volume
D. blood pressure

26
Q

A blood pH < 7.35 is known as __________.

A. acidosis
B. alkalosis

A

A. Acidosis

27
Q

Physiologic renal and respiratory adjustments to primary changes in pH are known as __________.

A. abnormal responses
B. compensation

A

B. compensation

28
Q

Total body water _________ in older adults due to decreases in fat and muscle mass, decreased kidney function, and impairment of thirst perception.

A. decreases
B. increases

A

A. decreases

29
Q

An abnormal increase in bicarbonate concentration causes _________

A. Metabolic alkalosis
B. metabolic acidosis
C. Respiratory acidosis
D. Respiratory alkalosis

A

A. Metabolic alkalosis

30
Q

Alveolar hyperventilation which results in low carbon dioxide levels results in ____________.

A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

A

D. respiratory alkalosis

31
Q

Hypercapnia is defined as _________.

A. Decreased level of plasma oxygen
B. Elevated level of plasma carbon dioxide
C. Decreased level of plasma carbon dioxide
D. Elevated level of plasma oxygen

A

B. Elevated level of plasma carbon dioxide

32
Q

The electrolyte imbalance of greatest concern for cardiac effects is:

A. hyperkalemia
B. hypokalemia
C. hyponatremia
D. Hypernatremia

A

A. Hyperkalemia

Pathophysiology (25 decks)

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