fluid, electrolytes, & acid base balance

Question 1

pH normal value

Answer 1

7.4-7.44

Question 2

pco2 normal value

Answer 2

40-44 mmHg

Question 3

sodium normal value

Answer 3

140-144

Question 4

potassium normal value

Answer 4

3.8-4.4

Question 5

bicarbonate normal value

Answer 5

24-28

Question 6

chloride normal value

Answer 6

99-104)

Question 7

anion normal value

Answer 7

3-10

Question 8

rule # 1

Answer 8

determine pH status. alkalemia or acidemia. >7.44=alkalosis <7.4=acidosis

Question 9

rule # 2

Answer 9

determine whether the primary processes respiratory, metabolic, or both. respiratory alkalemia: pco2 is substantially (+/-2) less than 40 mmHg. metabolic alkalemia: if bicarbonate is greater than 25.

Question 10

acidemia:

Answer 10

respiratory: pco2 is greater than 44. metabolic: bicarbonate is less than 25.

Question 11

what acid base combo can you not have at the same time?

Answer 11

respiratory acidosis and respiratory alkalosis

Question 12

rule # 3

Answer 12

calculate the serum ion gap

Question 13

anion gap=

Answer 13

sodium- (bicarbonate+chloride)

Question 14

anion gap interpretation

Answer 14

anion gap that is increased (greater than 10) can indicate metabolic acidosis. anion gap increased beyond 20 always indicates a metabolic acidosis. for every 1 g/dL albumin is less than normal at 2.5 to the calculated anion gap

Question 15

rule # 4

Answer 15

check the degree of compensation
metabolic acidemia: one decrease in pco2=1.3 decrease in bicarbonate.
metabolic alkalemia: one increase in pco2=.6 increase in bicarbonate

Question 16

acute respiratory acidemia

Answer 16

for every pCo2 decrease of 10 mmHg, bicarbonate decreases by 2

Question 17

chronic respiratory acidemia

Answer 17

for every pco2 increase of 10 mmHg, bicarb increases by 4 mEq per liter.

Question 18

acute respiratory alkalemia

Answer 18

for every pco2 decrease of 10 mmHg, bicarb decreases by 2

Question 19

chronic respiratory alkalemia

Answer 19

for every pco2 decrease of 10 mmHg, bicarb decreases by 5

Question 20

rule # 5

Answer 20

determine whether there is a 1:1 relationshop between anions in the blood (also called the delta gap). increases anion gap metabolic acidemia; every 1 point increase in anion gap should be accompanied by one mE/L decrease in bicarb. if the bicarb is higher than predicted by the 1:1, a metabolic alkalosis is also present. if the bicarb is lower than predicted 1:1 relationship,a normal anion gap metabolic acidosis is also present.