Facts Acids and Bases Flashcards
normal serum pH level is
7.35 - 7.45
acids are produced by
metabolism of protein, fat, and carbohydrates - acids can release hydrogen ions
acid byproducts are excreted through
lungs and kidneys
neutral on the pH scale is
7.0
values lower than 7.0 on the pH scale are considered
acidic
values higher than 7.0 on the pH scale are considered
alkaline/basic
the only volatile acid formed in the body is
carbonic acid (H2CO3)
the lungs help maintain acid-base balance by
being the respiratory system’s control of CO2 (acid)
the kidneys help maintain acid-base balance by
being the renal system’s control of bicarbonate (base) and hydrogen ions (H+) (acid)
the carbonic acid-bicarbonate buffering system operates in
the lungs and kidneys
the carbonic acid-bicarbonate buffering system is a major intracellular or extracellular buffer?
extracellular
carbonic acid is formed by
cellular respiration results in the production of CO2, which combines with water
lungs can increase and decrease pH by
excreting CO2 (acid)
reduce carbonic acid by blowing off CO2 and leaving water behind
increase carbonic acid by holding CO2 which combines with water to make more acid
kidneys increase and decrease pH by
excreting HCO3 (bicarbonate) (base) in urine
the protein buffering system is an intracellular or extracellular buffer?
intracellular
proteins have a _____ charge that allows them to _______ hydrogen ions
negative, join with
hemoglobin functions as a buffer by _______ hydrogen ions as the pH increases and _______ hydrogen ions as it decreases
losing, gaining
hemoglobin also binds to _______ and brings it to the ______ for release
CO2, lungs
the kidneys can rid the body of excess acids by
excreting hydrogen ions into the urine
kidneys reabsorb HCO3- (bicarb) back into the blood by combining with
phosphate
ammonia
respiratory alterations are caused by
increase/decrease in PaCO2
metabolic alterations are caused by
increase/decrease in hydrogen ions (H+) or bicarbonate ions (HCO3-)
acidosis is seen with
increased H+ ; decreased HCO3-
pH BELOW 7.35
respiratory or metabolic causes
alkalosis is seen with
decreased H+ ; increased HCO3-
pH ABOVE 7.35
respiratory or metabolic causes
respiratory acidosis is seen with
elevation of pCO2
ventilation depression
respiratory alkalosis is seen with
depression of pCO2
alveolar hyperventilation
metabolic acidosis is seen with
depression of HCO3- or increase in noncarbonic acids
metabolic alkalosis is seen with
elevation of HCO3- usually caused by excessive loss of metabolic acids
lungs compensate for changes in pH by
they can compensate fast or slow?
altering rate and depth of ventilation to increase or decrease concentration of carbon dioxide
fast (seconds to minutes)
kidneys compensate for changes in pH by
they can compensate fast or slow?
resorbing bicarbonate ions into the plasma and excreting H+ ions into the urine
slow (hours to days)
causes of metabolic acidosis
accumulation of acids
* ketoacidosis
* lactic acids
* renal failure
loss of bicarbonate
* diarrhea
metabolic acidosis compensatory mechanisms
bicarbonate buffering
H+ ion moves from plasma into a cell
lung mechanisms
increased ventilation
* deep rapid breaths “kussmaul respirations”
renal mechanisms
* eliminate H+
* retain HCO3-
metabolic acidosis clinical findings
LOW pH BELOW 7.35
LOW HCO3- bicarbonate BELOW 22 mEq/L (norm 22-26)
PaCO2 BELOW 40 mEq/L (norm 35-45)
normal or elevated anion gap
treatment for metabolic acidosis
IV Ringer’s lactate (contains bicarb/lactate)
Na bicarbonate IV
causes of metabolic alkalosis
loss of acid
* upper GI losses
* renal losses
* H+ moving into cells
accumulation of bicarbonate (base)
compensatory mechanisms of metabolic alkalosis
H+ move out of cells
decreased ventilation
* decreased CO2 blown off
* more acid (CO2 - carbonic) retained in plasma
renal mechanisms
* eliminate HCO3-
* retain H+
clinical findings of metabolic alkalosis
HIGH pH ABOVE 7.45
HIGH HCO3- bicarbonate ABOVE 26 mEq/L
PCO2 ABOVE 40mm Hg
chloride decreases
treatment for metabolic alkalosis
IV normal saline (NS) with KCL
treat underlying cause
common symptoms of metabolic alkalosis
weakness
muscle cramps
hyperactive reflexes
tetany
confusion
convulsions
atrial tachycardia
symptoms of metabolic acidosis
headache and lethargy which progress to confusion and coma in severe cases
causes of respiratory acidosis
hypoventilation
* respiratory center depression
* respiratory muscle alteratins
* CO2 retention
* airway obstruction
compensatory mechanisms of respiratory acidosis
acute - not done quickly
RBC ICF buffering (hemoglobin and phosphates)
renal buffering mechanism (works slowly)
chronic respiratory acidosis is well compensated
clinical presentations of respiratory acidosis
decreased level of consciousness (LOC)
cerebral vasodilation
LOW pH BELOW 7.35
HIGH PaCO2 ABOVE 45 mmHg
* acute case - normal
* chronic case - ABOVE 26 mEq/L
symptoms respiratory acidosis
headache
blurred vision
breathlessness
restlessness
apprehension
treatment of respiratory acidosis
restore ventilation
mechanical ventilation
administer oxygen carefully
causes of respiratory alkalosis
hyperventilation
* pain
* anxiety
* early stages of pulmonary disease
1. initial response to hypoxia
2. increased respiratory rate
3. later stages, CO2 accumulates, acidosis results
compensatory mechanisms of respiratory alkalosis
ICF buffering (hemoglobin)
renal decreased H+ excretion and decreased bicarbonate reabsorption
clinical presentations of respiratory alkalosis
respiratory rate rapid, deep
dyspnea, lightheaded
tingling (paresthesia)
HIGH pH ABOVE 7.45
LOW PaCO2 BELOW 35 mmHg
HCO3- (serum bicarbonate)
* acute case - normal
* chronic case - BELOW 22 mEq/L
treatment of respiratory alkalosis
treat cause
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