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Concepts > Exam 3: Acid Base Balance > Flashcards

Exam 3: Acid Base Balance Flashcards

1
Q

What systems maintain acid- base balance of the body?

A

1) The Lungs (Gas exchange)
2) Kidneys (Filtration and excretion of waste)
3) Buffer systems (Specifically in the heme).

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2
Q

What does faster and deeper breathing result in?

A

Faster and deeper breathing often results in More CO2 being exhaled alongside an increase in blood pH (and therefore less acidity).

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3
Q

How do the lungs help maintain the acid-base balance? Is this a quick or slow compensation process?

A

The gas exchange of the lungs provides red blood cells with oxygen while drawing CO2 (a mildly acidic waste product) from the blood and into the lungs for exhalation.

This is a quick compensation process in the event of an acid-base inbalance.

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4
Q

How do the kidneys help maintain the acid-base balance within the body? Is this a fast or slow compensation process?

A

The kidneys filter and excrete waste products from the blood, but this is fairly slow compensation process as it takes several days to correct any inbalance.

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5
Q

Name the 3 Acid-Base Buffer Systems.

A

1) Carbonic acid-Sodium bicarbonate System
2) Phosphate System
3) Protein System

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6
Q

REVIST SLIDE 5

A
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7
Q

REVISIT SLIDE 6

A
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8
Q

REVISIT SLIDE 6 (PROTEIN BUFFER SYSTEM)

A
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9
Q

What are normal ABG values/ranges?

A

pH= 7.35-7.45
PaCO2 (partial pressure of CO2) = 35-45 mm Hg
HCO3 (Bicarbonate)= 22-32 mEq/L
PaO2 (partial pressure of oxy)= 80-100 mm Hg
BE (Base Excess) +/= 2
saO2= 95-100%

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10
Q

What are Etiologies (causes) or Respiratory Acidosis?

A

1) Hypoventilation by any cause (i.e MI, Cardiac Arrest, CHF, CPD, Aspiration)
2) Pneumonia
3) Pulmonary Edema
4) COPD
5) Any medication that depresses RR.

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11
Q

What are the s/sx of Respiratory Acidosis?

A

Decreased LOC
Confusion
Lethargy
Tachycardia
Palpations
Flushed skin

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12
Q

What are possible treatments for Respiratory Acidosis?

A

Improve Ventilation (Oxygentation indicated)
Pharm therapies
Non-invasive positive pressure ventilation (CPAP or BiPAP)
Intubation and mechanical ventilation (LAST RESORT!)

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13
Q

What are Etiologies of Respiratory Alkalosis?

A

Hyperventilation
Extreme Anxiety
Early Sepsis
High Fever

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14
Q

What are s/sx of Respiratory Alkalosis?

A

Light headedness, dizziness, confusion, dry mouth, and heart palpitations.

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15
Q

What are possible treatments for Respiratory Alkalosis?

A

Treat underlying cause
Encourage pt. to slow their breathing
Breathing into a paperbag
Sedatives (with careful caution and monitoring!)

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16
Q

What is an Anion Gap? And when do providers typically search for an anion gap?

A

An Anion Gap is the difference between primary Cations (Na and K) and Primary Anions (Cl and HCO3).
Providers typically inspect for this gap in cases of altered mental status, acute renal failure, and unknown exposures.

17
Q

What are typical etiologies for Decreased Anion Gaps?

A

Hypoalbuminemia
Bromide Intoxication
Plasma Cell Dycrasia

18
Q

What are possible etiologies of Metabolic Acidosis?

A

DKA
Renal Failure
Lactic Acidosis
Toxins
Severe Diahrrea
Hyperlimentation

19
Q

What are s/sx of Metabolic Acidosis?

A

Headache, Confusion, Drowsiness
N/V
Tachypenea

20
Q

What are etiologies of Metabolic Akalosis?

A

Vomiting
Prolonged Gastric Suctioning
K wasting diuretics (Hypokalemia)

21
Q

What are possible treatments to Metabolic Acidosis?

A

Treatment of the underlying cause for metabolic defecit
Pharm therapy - NaHCO3 used VERY CAUTIOUSLY IN CASES OF HIGH ANION GAPS!
Renal Failure=Dialysis

22
Q

What are s/sx of metabolic Alkalosis?

A

Headache, weakness, lethargy
Neuromuscular problems (siezures, tetany, and delirium)

23
Q

What are possible treatments to Metabolic Alkalosis?

A

Treatment of underlying cause
admin of NaCl 0.9%
Correction of Hyperkalemia
Correction of Hypervolemia
Acetazolamide (Diamox) PO or IV
Hydrochloric Acid IV- CENTRAL LINE ONLY!
Dialysis in severe alkalosis (>7.6)

24
Q

What are typical Etiologies for Normal Anion Gap ranges?

A

Loss of HCO3
Renal Tubular Acidosis
Illesotomy Fluid Loss

25
Q

What are common etiologies for increased anion gaps?

A

DKA
Renal Failure
Uremia (raised levels of blood and nitrogenous waste, normally excreted by the kidneys)

26
Q

What is the normal range of an Anion Gap?

A

3-11 mEq/L

27
Q

What is the equation for determining an anion gap?

A

NA - (Cl+HCO3)

Concepts (11 decks)

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