Exam 3 - Acid Base Balance Flashcards
what is an acid
substances that release hydrogen ions when dissolved in fluid and increase amount of free H
what is a base
binds free hydrogen ions in solution and lowers amount of free H
what is a buffer
tries to keep pH at normal levels - can bind hydrogen or release
what is the most common base in the human body
HCO3 (bicarbonate)
what is the most common acid in the human body
H2CO3 (carbonic acid)
what is the ratio of H2CO3 and HCO3 in the human body
1 H2CO3 : 20 HCO3
what does carbohydrate make as a waste product in normal metabolism
carbon dioxide
what does protein make as a waste product in normal metabolism
sulfuric acid
what does fat make as a waste product in normal metabolism
ketoacids
what are the two buffers? and where are they active?
phosphate (ICF) and bicarb (both ECF and ICF)
what are the two types of ECF protein buffers?
albumin and globulins
what is the ICF protein buffers?
hemoglobin
what are the kidneys defense for regulation
form ammonium, form acids or movement of bicarbonate
what happens in acidosis
excess amount of hydrogen ions (pH below 7.35)
what is actual acidosis
overproduction(release of H) or under elimination of acids (retention of H)
what is relative acidosis
amount of acids do not increase, amount of strength of bases decrease
where do the first manifestations occur for acidosis?
musculoskeletal, cardiac, respiratory, and central nervous system
what happens when there is a overproduction of hydrogen ions under elimination of hydrogen ions underproduction of bicarbonate ions and over elimination of bicarbonate ions?
metabolic acidosis
how does overproduction of hydrogen ions cause metabolic acidosis
excessive breakdown of fatty acids
anaerobic glucose breakdown (lactic acidosis)
excessive intake of acids
how is respiratory acidosis caused?
retention of co2
what are the four conditions that may cause respiratory acidosis?
respiratory depression
inadequate chest expansion
airway obstruction
reduced alveolar-capillary diffusion
interventions of metabolic acidosis?
drugs and fluid
interventions of respiratory acidosis?
drug therapy (bronchodilator, anti-inflammatory, mucolytics)
oxygen therapy
ventilation therapy
preventing complications
what is alkalosis
a decrease in hydrogen ions
what are the problems most caused by alkalosis?
neuromuscular, cardiac, nervous
what causes metabolic alkalosis?
excessive intake of carbonates, acetates and citrates
disease process and medical therapy
what causes resiratory alkalosis?
excessive loss of co2
what are the numbers for the pH of pCO2
35 below is alkalotic
45 and above is acidotic
what are the numbers for the pH of HCO3
22 and below is acidotic
26 and above is alkalotic
what is the mnemonic for metabolic and respiratory?
Respiratory
Opposite
Metabolic
Equal
How do you determine the origin of the imbalance?
which one matches the same acid base status as the pH
how do you determine compensation?
present if opposite direction
absent if one component abnormal and other normal
what is partial compensation?
when pH remains outside the normal range
respiratory acidosis is also known as
hypoventilation
respiratory alkalosis is also known as
hyperventilation
tachycardia dysrhythmias anxiety irritability confusion coma
respiratory acidosis
tachypnea palpitations chest pain dysrhythmias anxiety tetany convulsions tingling/numbness
respiratory alkalosis
bradycardia tachypnea hypotension dysrhythmias fatigue weakness lethargy confusion anorexia nausea vomiting diarrhea
metabolic acidosis
tachycardia hypotension dysrhytmnias numbness tingling tetany muscle weakness hyporeflexia confusion convulsions polyuria polydipsia
metabolic alkalosis
what is metabolic alkalosis
excessive loss of metabolic acids
bicarb increases
how does the respiratory system compensate for metabolic alkalosis
slow shallow breaths
co2 retained
paCO2 increase
what is metabolic acidosis
bicarbonate loss - too much H+ produced
what is respiratory alkalosis
carbonic levels fall and pH rises
more than normal co2 is exhaled
how does the respiratory alkalosis get compensated
kidneys excrete bicarbonate or hyperventilation stops
what causes respiratory alkalosis
hyperventilation
fever
aspirin toxication
what is respiratory acidosis
carbonic levels increase and pH decreases
co2 retention
how does respiratory acidosis get compensated
kidneys retain bicarbonate and eliminate hydrogen
what lung diseases causes respiratory acidosis
asthma copd penumonia pulmonary edema respiratory muscle wall paralysis
what CNS depression causes respiratory acidosis
anesthesia
narcotic overdose
head injury
what is the main treatment for respiratory acidosis
increase ventilation to blow off co2!!
