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Nurs365 E1 Fluids and Electrolytes, Acids and Bases > Facts Acids and Bases > Flashcards

Facts Acids and Bases Flashcards

1
Q

normal serum pH level is

A

7.35 - 7.45

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2
Q

acids are produced by

A

metabolism of protein, fat, and carbohydrates - acids can release hydrogen ions

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3
Q

acid byproducts are excreted through

A

lungs and kidneys

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4
Q

neutral on the pH scale is

A

7.0

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5
Q

values lower than 7.0 on the pH scale are considered

A

acidic

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6
Q

values higher than 7.0 on the pH scale are considered

A

alkaline/basic

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7
Q

the only volatile acid formed in the body is

A

carbonic acid (H2CO3)

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8
Q

the lungs help maintain acid-base balance by

A

being the respiratory system’s control of CO2 (acid)

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9
Q

the kidneys help maintain acid-base balance by

A

being the renal system’s control of bicarbonate (base) and hydrogen ions (H+) (acid)

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10
Q

the carbonic acid-bicarbonate buffering system operates in

A

the lungs and kidneys

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11
Q

the carbonic acid-bicarbonate buffering system is a major intracellular or extracellular buffer?

A

extracellular

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12
Q

carbonic acid is formed by

A

cellular respiration results in the production of CO2, which combines with water

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13
Q

lungs can increase and decrease pH by

A

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

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14
Q

kidneys increase and decrease pH by

A

excreting HCO3 (bicarbonate) (base) in urine

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15
Q

the protein buffering system is an intracellular or extracellular buffer?

A

intracellular

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16
Q

proteins have a _____ charge that allows them to _______ hydrogen ions

A

negative, join with

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17
Q

hemoglobin functions as a buffer by _______ hydrogen ions as the pH increases and _______ hydrogen ions as it decreases

A

losing, gaining

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18
Q

hemoglobin also binds to _______ and brings it to the ______ for release

A

CO2, lungs

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19
Q

the kidneys can rid the body of excess acids by

A

excreting hydrogen ions into the urine

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20
Q

kidneys reabsorb HCO3- (bicarb) back into the blood by combining with

A

phosphate
ammonia

21
Q

respiratory alterations are caused by

A

increase/decrease in PaCO2

22
Q

metabolic alterations are caused by

A

increase/decrease in hydrogen ions (H+) or bicarbonate ions (HCO3-)

23
Q

acidosis is seen with

A

increased H+ ; decreased HCO3-
pH BELOW 7.35
respiratory or metabolic causes

24
Q

alkalosis is seen with

A

decreased H+ ; increased HCO3-
pH ABOVE 7.35
respiratory or metabolic causes

25
Q

respiratory acidosis is seen with

A

elevation of pCO2
ventilation depression

26
Q

respiratory alkalosis is seen with

A

depression of pCO2
alveolar hyperventilation

27
Q

metabolic acidosis is seen with

A

depression of HCO3- or increase in noncarbonic acids

28
Q

metabolic alkalosis is seen with

A

elevation of HCO3- usually caused by excessive loss of metabolic acids

29
Q

lungs compensate for changes in pH by
they can compensate fast or slow?

A

altering rate and depth of ventilation to increase or decrease concentration of carbon dioxide
fast (seconds to minutes)

30
Q

kidneys compensate for changes in pH by
they can compensate fast or slow?

A

resorbing bicarbonate ions into the plasma and excreting H+ ions into the urine
slow (hours to days)

31
Q

causes of metabolic acidosis

A

accumulation of acids
* ketoacidosis
* lactic acids
* renal failure
loss of bicarbonate
* diarrhea

32
Q

metabolic acidosis compensatory mechanisms

A

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-

33
Q

metabolic acidosis clinical findings

A

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

34
Q

treatment for metabolic acidosis

A

IV Ringer’s lactate (contains bicarb/lactate)
Na bicarbonate IV

35
Q

causes of metabolic alkalosis

A

loss of acid
* upper GI losses
* renal losses
* H+ moving into cells
accumulation of bicarbonate (base)

36
Q

compensatory mechanisms of metabolic alkalosis

A

H+ move out of cells
decreased ventilation
* decreased CO2 blown off
* more acid (CO2 - carbonic) retained in plasma
renal mechanisms
* eliminate HCO3-
* retain H+

37
Q

clinical findings of metabolic alkalosis

A

HIGH pH ABOVE 7.45
HIGH HCO3- bicarbonate ABOVE 26 mEq/L
PCO2 ABOVE 40mm Hg
chloride decreases

38
Q

treatment for metabolic alkalosis

A

IV normal saline (NS) with KCL
treat underlying cause

39
Q

common symptoms of metabolic alkalosis

A

weakness
muscle cramps
hyperactive reflexes
tetany
confusion
convulsions
atrial tachycardia

40
Q

symptoms of metabolic acidosis

A

headache and lethargy which progress to confusion and coma in severe cases

41
Q

causes of respiratory acidosis

A

hypoventilation
* respiratory center depression
* respiratory muscle alteratins
* CO2 retention
* airway obstruction

42
Q

compensatory mechanisms of respiratory acidosis

A

acute - not done quickly
RBC ICF buffering (hemoglobin and phosphates)
renal buffering mechanism (works slowly)
chronic respiratory acidosis is well compensated

43
Q

clinical presentations of respiratory acidosis

A

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

44
Q

symptoms respiratory acidosis

A

headache
blurred vision
breathlessness
restlessness
apprehension

45
Q

treatment of respiratory acidosis

A

restore ventilation
mechanical ventilation
administer oxygen carefully

46
Q

causes of respiratory alkalosis

A

hyperventilation
* pain
* anxiety
* early stages of pulmonary disease
1. initial response to hypoxia
2. increased respiratory rate
3. later stages, CO2 accumulates, acidosis results

47
Q

compensatory mechanisms of respiratory alkalosis

A

ICF buffering (hemoglobin)
renal decreased H+ excretion and decreased bicarbonate reabsorption

48
Q

clinical presentations of respiratory alkalosis

A

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

49
Q

treatment of respiratory alkalosis

A

treat cause
paper bag

Nurs365 E1 Fluids and Electrolytes, Acids and Bases (4 decks)

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