Exam 2: chapter 5 (Acid-Base) Flashcards
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. uses bicarbonate, hemoglobin, phosphate, and plasma proteins to instantaneously contribute to acid-based corrections (per chemical reactions)
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
B. compensates by increasing ventilation to expire carbon dioxide or by decreasing ventilation to retain carbon dioxide- control CO2
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
C. compensates by producing acid or alkaline urine
Define respiratory acidosis
Alveolar Hypoventilation
* Results Hypercapnia
o Increases CO2
Alveoli not exchanging –> hypoperfusion
Ventilation (ability to breath –> hypoventilation
* pH < 7.35; PaCO2> 45 mmHg
What are some causes of respiratory acidosis?
*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
What are some clinical manifestations of respiratory acidosis?
headache, blurred vision, breathlessness, restlessness, progressing to disorientation, convulsions, coma - neurological effects
during respiratory acidosis, how does the body compensate?
Kidneys compensate by eliminating H ions and retaining HCO3
Define respiratory alkalosis
o Alveolar Hyperventilation (deep, rapid respirations)
Results in Hypocapnia (decreased PaCO2)
pH > 7.45; PaCO2< 35 mmHg
o Acute or chronic
What are some causes of respiratory alkalosis?
o Causes: HYPERVENTILATION!
Hypoxemia (brain injury, pulmenary disease, CHF, altitude)
Hypermetabolic states (fever)
Anxiety/hysteria
Meds/chemicals that increase the RR - stimulants
what are some clinical manifestations of respiratory alkalosis?
Dizziness, confusion, syncope, convulsions, coma - neuro, not enough
during respiratory alkalosis, how does the body compensate?
Kidneys compensate by conserving H ions and eliminating HCO3 –> balance
define Metabolic acidosis
an accumulation of acid in the body
list some causes of metabolic acidosis
○ Ketoacidosis: too much acid
○ Lactic acid accumulation (shock, hypoxemia)
○ Severe diarrhea: losing bicarb
○ Kidney disease
○ Ingestions (aspirin, antifreeze)
list some clinical manifestations of metabolic acidosis
Changes in function of the neurologic, respiratory, GI and CV system
how does the body compensate for metabolic acidosis?
- Buffering systems/Lungs compensate blowing off CO2
-Hyperventilation (lungs not the issue)/Kussmaul respirations - kidneys conserve HCO3 and eliminate H+ ions in acidic urine
Define metabolic alkalosis
the body’s pH is elevated to more than 7.45
o Base bicarbonate excess or loss of acid
what are some causes of metabolic alkalosis?
○ Prolonged vomiting or gastric acid suction - increase base
○ Gain of HCO3
○ Diuretics (promote excretion of Na+, K+ and Cl-, not as much HCO3)
list clinical manifestations of metabolic alkalosis
○ Weakness, muscle cramps, hyperactive reflexes, tetany, confusion, convulsions
○ Increases the binding of calcium to plasma proteins, causing hypocalcemia
How does the body compensate during metabolic alkalosis?
Lungs compensate partially by retaining CO2 (decreasing respiratory rate) - decreasing RR
Kidneys conserve H+ ions and eliminate HCO3 in alkaline urine
Interpret this ABG:
- pH 7.32
- PaCO2 67 mm Hg
- HCO3 25 mEq/L
- PaO2 47 mm Hg
What is this acid/base alteration?
respiratory acidosis with hypoxemia
Interpret this ABG:
- pH 7.18
- PaCO2 38 mm Hg
- PaO2 70 mm Hg
- HCO3 15 mEq/L
What is this acid/base alteration?
Metabolic acidosis with hypoxemia
Interpret this ABG:
- pH 7.60
- PaCO2 30 mm Hg
- PaO2 60 mm Hg
- HCO3- 22 mEq/L
What is this acid/base alteration?
respiratory alkalosis with hypoxemia
Natriuretic peptides are hormones primarily produced by the __________.
A. pituitary gland
B. myocardium
C. kidneys
D. hypothalamus
B. myocardium
______________, located in the hypothalamus, are stimulated to produce thirst when increased osmolality occurs.
A. Renin
B. Natriuretic peptides
C. Hormones
D. Osmoreceptors
D. Osmoreceptors
