Exam 3- Acid Base Balance

Question 1

What is going on during the Acid Base balance?

Answer 1

CO2+H20–H2CO3 (bicarbonic acid)–H+ + HCO3- (bicarbonate)
LUNGS and KIDNEYS works together to maintain homeostasis
Lungs-respiratory (fast)
Kidneys- metabolic (slow)

Question 2

What 3 arterial blood gas values maintain homeostasis?

Answer 2

1. pH: 7.35-7.45
2. PaC02: 35-45 (respiratory)
3. HC03-: 22-26 (metabolic)

Question 3

Where are ABG’s located?

Answer 3

Lower than veins therefore analyze ABG’s

Question 4

When should you check ABGs every hour?

Answer 4

Pt who overdosed on Aspirin

Question 5

Interpretation of ABG’s: ROME

Answer 5

Respiratory-Opposite

Metabolic-Equal

Question 6

RO- Respiratory Opposite

Answer 6

Increased pH, Decreased PaCo2- Respiratory Alkalosis

Decreased pH, Increased PaCo2- Respiratory Acidosis

Question 7

ME- Metabolic Equal

Answer 7

Increased pH, Increased HCO3-= Metabolic Alkalosis

Decreased pH, Decreased HCO3-= Metabolic Acidosis

Question 8

What can cause compensated respiratory acidosis?

Answer 8

Long standing respiratory insufficiency e.g- COPD chronic obstructive pulmonary disease

Question 9

What can cause respiratory acidosis?

Answer 9

HYPOVENTILATION- CO2 builds up
RESPIRATORY FAILURE: ASTHMA, EMPHESEMIA therefore pt TRAPS TOO MUCH CO2 in lungs and C02 expands causing resp. acidosis. BRONCHITIS
PNEUMONIA

Question 10

Nursing interventions for pt experiencing resp acidosis to help start breathing?

Answer 10

oxygen therapy
semi-fowlers position
percussion test, chest physiotherapy
spirometer
sputum suctioning
ASSIST PT WITH THESE^

Question 11

What causes Respiratory Alkalosis?

Answer 11

HYPERVENTILATION: exhaling too much C02 (getting rid of) because breathing too fast.
Caused by: TRAUMA pt in shock or ventillator setting is inappropriate for pt in ICU

Question 12

Nursing interventions for pt in respiratory alkalosis?

Answer 12

Have pt breathe in PAPER BAG so that they can breathe in the CO2.
Pt breathe in a MASK
REASSURANCE: person in car accident, child or someone injured therefore parent’s breathing becomes RAPID..bring parent back to HOMEOSTASIS..breathe bitch breathe in a bag!

Question 13

What causes metabolic acidosis?

Answer 13

anaerobic metabolism
lactic acidosis
anoxia
renal failure
poisoning 
overdose

Question 14

What is the most common metabolic acidosis?

Answer 14

DIABETIC KETOACIDOSIS- breakdown of fat in body, that process causes release of ketones (acidic, high) in diabetic pt. therefore ketones released in blood, which are highly acidic= metabolic acidosis!

Question 15

Nursing interventions for metabolic acidosis?

Answer 15

Take seizure percautions

Monitor I&Os

Question 16

What causes Metabolic Alkalosis?

Answer 16

1. ANTACIDS- excess Tums, alkaseltzer or antacid use excessively
2. GASTRIC LOSS- e.g NG tube, loss of stomach fluid, HCL acid loss in stomach therefore shift to become alkalodic.
   Effects: VOMITING, POISONING, OVERDOSE

Question 17

Nursing interventions for metabolic alkalosis?

Answer 17

1. Teach encourage- do not use antacids

2. Put pt on meds to help gastric loss subside