Module 05: Fluids, Electrolytes, and Acid Base Flashcards
1
Q
This is a state of equilibrium stabilization of body functions to maintain normal status.
A
Homeostasis
2
Q
This pertains to extracellular fluid volume deficit.
A
Dehydration
3
Q
This pertains to extracellular fluid volume excess.
A
Fluid Overload
4
Q
This pertains to the absorption back to the
bloodstream, which retained in the body
A
Reabsorption
5
Q
This pertains to the tonicity.
A
Osmolality
6
Q
What is fluid content of infants?
A
70% - 80%
7
Q
What is fluid content of an adult male?
A
50% - 70 %
8
Q
What is fluid content of an adult female?
A
50% - 60 %
9
Q
What is fluid content of an old adult and obesity?
A
45% - 55%
10
Q
How much intercellular fluid (ICF) is in the body?
A
2/3 of fluid within the cell
11
Q
How much extracellular fluid (ECF) is in the body?
A
1/3 of Fluid outside cells
12
Q
This pertains to the fluid in between cells (lymph)
A
Interstitial Fluid
13
Q
This pertains to the Fluid within the blood vessels
A
Intravascular Fluid
14
Q
This pertains to the fluid in small and specialized
cavities (synovium, CSF, pleura and peritoneum).
A
Transcellular fluid
15
Q
How much plasma is in the body?
A
3L
16
Q
How much interstitial fluid is in the body?
A
10L
17
Q
How much intracellular fluid is in the body?
A
28L
18
Q
What are the functions of body water?
A
(1) Stabilizes body temperature
(2) Protection
(3) Chemical Reactions
(4) Transport
19
Q
This function of body water pertains to the high heat capacity of water allows it to absorb and release large amounts of heat before changing temperature
A
Stabilizes body temperature
20
Q
This function of the body water pertains to how it acts as a lubricant or cushion.
A
Protection
21
Q
This function of body water pertains to its polar solvent properties: dissolves ionic substances, forms hydration layers around large charged molecules, and serves as the body’s major
transport medium
A
Transport
22
Q
What is the percentage by volume of plasma and formed elements from blood?
A
55% - Plasma
45% - formed elements from Blood
23
Q
What constitutes the plasma?
A
7% - proteins 2% - other solutes
91% - water
24
Q
What constitutes the formed elements (number per cubic mm)?
A
(1) Platelets (250-400,000)
(2) White blood cells (5,000 - 9,000)
(3) Red blood cells (4.2 million - 6.2 million)
25
What constitutes proteins?
(1) Albumins ( 58%)
(2) Globulins (38%)
(3) Fibrinogen (4%)
26
This is a substance capable of dissolving a solute. Its dissolves medium is H2O. It may be in form of gas or liquid
Solvent
27
This is a substance that is dissolved in a solvent. It may be in the form of gas, liquid or solid
Solute
28
This is a mixture of 2 or more particles that are exceedingly small
Solutions
29
This is a mixture of 2 or more components; particles are fairly large
Suspension
30
This is a translucent mixtures with solute particles of intermediate size
Colloids
31
This pertains to the movement of solute and
water across a semipermeable membrane
Filtration
32
This is a use of a machine and a “filtration membrane"
Dialysis
33
This is the the movement of a solute from an area of higher concentration to an area of lower concentration within a solvent nor a membrane. It transpires at equilibrium, there is a uniform distribution of molecules
Diffusion
34
These transports are important for ATP, which is the source and transport of energy.
(1) Passive Transport
(2) Active Transport
35
This stores and provides energy. Moreover, this is the source of immediately usable energy for the cell
Adenosine Triphosphate (ATP)
36
This is required for energy to be assimilated in our muscles.
Insulin
37
In this, the three sodium ions (Na ++) and adenosine triphosphate (ATP) bind to the Na K pump (where potassium and sodium is exchanged), which is an ATP powered pump.
Facilitated transport though Sodium Potassium Pump
38
How does Facilitated transport though Sodium Potassium Pump control fluid and electrolyte movement?
As sodium (Na ++) diffuses into the cell and potassium (K ++) diffuses out of the cell, an active transport system supplied with energy delivers Na back to the extracellular compartment and K to the intracellular compartment.
39
This is the diffusion of a solvent (water ) across a
selectively (semi) permeable membrane from an area of low solute concentration to an area of high solute concentration.
Osmosis
40
The measurement of osmosis depends on the __________ and __________ of fluids.
osmolality and osmotic pressure
41
This is used to describe the tonicity of the blood plasma/serum
Osmolality (275 - 300 umol/L)
42
This pertains to osmolality higher than normal
Hyperosmolality
43
This pertains to osmolality lower than normal
Hypoosmolality
44
Osmolarity is used to describe all other fluids based on the content of what in a solution?
Salt and Sugar
45
What is the osmolarity of IV Fluids - D5%W?
Normal Saline, Isotonic
46
What is the osmolarity of drinks like soda, gatorade, and juice as well as tube feeding (ensure)?
Hyperosmolar
47
What is the osmolarity of food and plain water?
Hypotonic
48
This is the osmotic pressure between two compartments.
Tonicity
49
This is the pressure that needs to be applied to a solution to move through a semi permeable membrane, commonly called "concentration of a solution."
Osmotic pressure
50
This pertains to your blood pressure.
Hydrostatic Pressure.
51
This is contingent on proteins and is equal to pi. This retains the fluid within the interstitial space
Oncotic Pressure
52
Explain “Starling’s Law of Fluids”
Dynamics of fluid exchange between a capillary and tissue. An equilibrium exists between forces filtering
fluid out of the capillary and forces absorbing fluid back into the capillary. Note that the hydrostatic pressure is greater at the arterial end of the capillary than at the venous end. The net effect of pressures at the arterial end of the capillary causes a movement of fluid into the tissue. At the venous end of the capillary, there is net movement
of fluid back into the capillary.
53
How much pressure is in the arterial end?
40 mmHg
54
How much pressure is in the venous end?
1 0 mmHg
55
These are shifts of plasma fluid to interstitial
space/compartment
Edema
56
What causes edema?
(1) Elevation of venous hydrostatic pressure
(2) Decrease in plasma oncotic pressure
(3) Elevation of interstitial oncotic pressure
57
What are the different types of regulation of water balance?
(1) Hypothalamic Regulation
(2) Pituitary Regulation
(3) Adrenal Cortical Regulation
58
What is the effect plasma osmolality on water intake?
An increased osmolality (caused by sugar or salt intake) or large decrease on blood pressure causes an increased thirst
Polyurea - excessive urinating
Polydipsia - excessive thirst
Polyphagia - excessive hunger
59
What are the effects of the increase extracellular fluid osmolality?
This stimulates thirst and ADH secretion
(1) Increased fluid intake
(2) Increased water reabsorption in the kidneys
60
What are the effects of the decrease extracellular fluid osmolality?
A decrease in extracellular osmolality inhibits thirst
and decreases ADH secretion
(1) Decreased fluid intake
(2) Decreased water reabsorption in the kidneys
61
This is produced by the heart when blood pressure
increases. Moreover, it inhibits Na+ reabsorption in the kidneys, resulting in increased urine volume and
decreased blood volume and blood pressure. It also inhibits ADH secretion and dilates arteries and veins
Atrial Natriuretic Hormone (ANH)
62
How does Atrial Natriuretic Hormone (ANH) regulate Na and Water?
When there is an increase in blood pressure in the right atrium, there is also an increase ADH, thus resulting to Na excretion and increased water loss and decreased BP.
63
This type of regulation is stimulated by the renin-angiotensin-aldosterone system
Renal Regulation
64
This type of regulation is stimulated by the Antidiuretic hormone (ADH) .
Cardiac Regulation
65
This type of regulation is tsimulated by 90% intake; 10% metabolism (Absorption and reabsorption)
Gastrointestinal Regulation
66
In terms of dehydration, how does it increase plasma volume?
(1) Stimulation of Thirst
(2) Brain (hypothalamus) release ADH
(3) Water reabsorption transpires in the collecting ducts
(4) This results to a decrease in Urination along with the conservation of body water which leads to an increase in plasma volume
67
In terms of hyperosmolality, how does it increase plasma volume?
(1) The kidney stimulates renin the gastrointestinal tract
(2) Renin converts to angiotensin I to angiotensin II
(3) This results to the release of aldosterone by the adrenal cortex, which then conserves Na+ and H2O
(4) Thus resulting to an increase in plasma volume
68
Where does insensible water loss happen?
Lungs, GI tract, skin
69
How much volume of water is loss in high fluid volume loss?
900mL
70
What is the average volume of water loss per day?
600 mL
71
How do you compute water loss in children?
300 mL x BSA
72
This is the major ion in the extracellular fluid.
Sodium (135 - 145 mEq/L)
73
What is the route of excretion of sodium?
Urine and Sweat
74
How is sodium regulated?
It is regulated by the efferent and afferent arterioles in the kidney. It decreases BP and relaxes Afferent
arteriole of the kidney to stimulate Renin
75
What affects the excretion of sodium?
Atrial natriuretic hormone (ANH) and Antidiuretic hormone (ADH)
76
What is the major roles of sodium?
(1) ECF volume and concentration
(2) Generation and transmission of nerve impulses
(3) Acid-base
77
What are the food rich in sodium?
*All cured meats
*All canned Foods
*All Junk food
*All condiments
78
This pertains to the condition on the increased intake of salt or near drowning or nephrogenic diabetes or insipidus. It is manifested by headache, thirst, lethargy, agitation, seizures, and coma. It also impairs the level of consciousness.
Hypernatremia
79
What is the critical value of hypernatremia?
CNS changes>155 mEq/L
80
How does a nurse diagnose hypernatremia?
* Risk for injury/falls related to CNS excitability and orthostatic hypotension
* Potential complications: seizures, coma
* Impaired skin Integrity related to dehydration: cracked and parched oral mucous membranes or skin irritation from diarrhea
81
This condition pertain to the loss of sodium containing fluids or from water excess (fluid restriction).
Hyponatremia
82
What is the symptoms of hyponatremia?
* Headache
* Confusion
* Dizziness
* Personality changes
* Tremors
* Seizures, coma (giver hypertonic saline solution 3%
83
What is the serious and critical value of hyponatremia
125 and 115 mEq/L respectively
84
How does a nurse diagnose hyponatremia?
* Potential risk for injury related to postural
hypotension, dizziness and neuro changes
* Potential complications: falls, seizure
85
The diet is the major source of this. The normal route of excretion transpires within the kidneys. The normal Mg level is required for the normal function of the Na+ and K pump.
Potassium
86
What is the normal values of potassium?
3.5 - 4.5 mEq/L
87
Where is potassium found?
96% intracellular and 4% intravascular
88
What is the critical value of potassium?
>8 (cardiac arrest)
89
What is the role of potassium?
(1) Transmission and conduction of nerve and muscle impulses
(2) Cellular growth
(3) maintenance of cardia rhythms
(4) Acid-base balance
90
This pertains to the increase intake, impaired renal excretion, adrenal insufficiency, and shift from ICF to ECF from high serum potassium
Hyperkalemia (caused by increased intake, wrong medication, Kidney Failure, Adrenal Insufficiency, Drug Induced (side effect)
91
What are the symptoms of hyperkalemia?
(1) Muscle weakness (legs)
(2) Paresthesia (weak or paralyzed skeletal muscles)
(3) Abdominal cramps or diarrhea
(4) Cardiac: irregular pulse, EKG changes (tall peaked T waves, prolonged PR interval and ST segment depression (ventricular fibrillation or cardiac standstill)
92
In ECG Changes, how is hyperkalemia manifested?
Tall PT waves
93
How do nurses perceive hyperkalemia?
* Risk for injury related to neuromuscular instability
* Potential complications: falls, seizures, dysrhythmias and cardiac arrest
* Potential Nutritional deficit
* Skin Impairment (if present with diarrhea)
94
This is a low serum potassium caused by abnormal losses of K+ via the kidneys or gastrointestinal tract (severe diarrhea), magnesium deficiency, metabolic alkalosis, and anorexia nervosa
Hypokalemia
95
What are the symptoms of hypokalemia?
* Weakness, fatigue (skeletal muscle and respiratory muscles)
* Decreased muscle tone, leg cramps
* Cardiac changes: Bradycardia
* Paresthesia
96
In ECG Changes, how is hypokalemia manifested?
ST segment depression,
flattened T wave, presence of U wave
97
How does a nurse perceive hypokalemia?
* Risk for injury related to neuromuscular instability
* Potential complications: falls, seizures, dysrhythmias and cardiac arrest
* Potential Nutritional deficit
* Skin Impairment (if present with diarrhea
98
This is a component of the skeletal system along with phosphorus that constitutes about 99% of it. It has an inverse relationship with PO4. And comes as free or ionized.
Calcium
99
What is the normal range of calcium?
9 to 11 mg/dL
100
Where is calcium obtained?
50% bound to protein (albumin) obtained from ingested foods.
101
What is the role of calcium?
(1) Bones are readily available store
(2) Blocks sodium transport and stabilizes cell membrane (Maintains cellular permeability)
(3) Plays a role in clotting (prothrombin to thrombin) (4)Transmission of nerve impulses
(5) Myocardial contractions
(6) Muscle contractions
102
What is responsible for controlling the levels of calcium?
(1) Parathyroid Hormone
(2) Calcitonin Thyroid Gland
(3) Synthesis or absorption of Vitamin D (Calcitriol) GI Tract
103
Calcium needs to be regulated in the:
* Gastrointestinal tract
* Blood
* Bones
104
How does the parathyroid hormone help regulate calcium levels?
PTH helps increase Calcium reabsorption into the bones with by the mobilization of osteoclast (prevents demineralization) through negative feedback mechanism
105
How does the calcitonin help regulate calcium levels?
Calcitonin produced by the thyroid gland helps in bone
deposition to resolve too much calcium in the bloodstream by using the osteoblasts
106
This allows the absorption of Calcium.
Calcitriol
107
This pertains to high levels of calcium in the blood.
Hypercalcemia
108
Hypercalcemia can be caused by which factors?
(1) Hyperparathyroidism
(2) Prolonged Immobilization
(3) Overdose of Vitamin D
(4) Multiple Myeloma, Ca with malignancy to bone
(5) Thiazides
109
What is the relationship between acidosis and calcium levels?
decreased pH increase ionized Ca
110
How is hypercalcemia manifested?
(1) Weakness, lethargy, forgetful, confusion, personality changes, psychosis
(2) Depressed reflexes (Fatigue)
(3) Anorexia, Nausea, Vomiting, dehydration, polyuria
(4) Bone pain
(5) Pathologic fracture
111
What is the EKG changes of hypercalcemia?
Shortened ST segment, shortened QT
112
What is the nursing diagnosis of hypercalcemia?
* Risk for injury related to neuromuscular and sensorium
changes
* Potential complications: Irregular HR, Bone fractures
* Bone Pain
* Decreased functional status
113
This diseases pertains to low serum calcium levels.
Hypocalcemia
114
What causes hypocalcemia?
(1) Decreased production of Parathyroid Hormone
(2) Acute pancreatitis (kidney failure)
(3) Multiple blood transfusions
(4) Alkalosis
(5) Decreased Intake of calcium
(6) Hx ETOH abuse (poor absorption of Vitamin D, PO4 and
Mg deficiency) or Abuse of diuretics
115
Hypocalcemia can be manifested through:
(1) Hyperreflexia, muscle cramps
(2) Numbness and tingling (extremities and region around the mouth)
(3) Depression, anxiety, confusion, easily fatigability (chronic)
(4) Severe cases: Tetany, seizures
(5) Dysphagia
(6) Positive Trousseau's (carpal spasm) and Chvostek's sign (facial twitching)
116
This is a manifestation of hypocalcemia that pertains to carpal spasm.
Positive Trousseau's
117
This is a manifestation of hypocalcemia that pertains to facial twitching.
Chvostek's sign
118
How do you observe Chvostek's sign?
Tap the face and observe Twitching
119
How do you observe Trousseau’s sign?
Observe Carpal spasms, as you inflate BP cuff above systolic pressure
120
What are the cardiac signs of hypocalcemia?
(1) Elongation of ST segment
(2) Prolonged QT interval
(3) Ventricular Tachycardia
121
What is the nursing diagnosis for hypocalcemia?
(1) Risk for injury related to weakness
(2) Alterations in functional status
(3) Potential complications: seizure, pathologic fracture neuromuscular changes & arrhythmias
(4) Bone Pain
122
This is an intracellular fluid ion that is essential to muscle, cell membranes, and red blood cells along your neuro functions.
Phosphate
123
What is the normal values of phosphate?
2.3 - 4.5 mg/dL
124
How is phosphate deposited and excreted?
Deposited within bones and teeth and excreted by the kidneys
125
What is the function of phosphate?
(1) Involved in acid-base buffer system, ATP production and cellular uptake of glucose
(2) Involved in metabolism of CHO (carbohydrates), fats and CHO-N (proteins)
126
What is the relationship between the calcium and the phosphate?
Inverse relationship (reciprocal relationship)
127
This is a condition caused by the high serum of PO4^3 (phosphate).
Hyperphosphatemia
128
What causes Hyperphosphatemia?
(1) Acute or chronic renal failure
(2) Chemotherapy for certain malignancies
(3) Excessive ingestion of phosphate or vitamin D
(4) Hypoparathyroidism
129
How is Hypoparathyroidism manifested?
(1) Calcified deposition in soft tissues such as joints, viscera arteries, skin, kidneys and corneas.
(2) Neuromuscular irritability and tetany
130
This is a condition caused by the low serum of PO4^3 (phosphate).
Hypophosphatemia
131
What causes Hypophosphatemia?
(1)Malnourishment or malabsorption
(2) Alcohol withdrawal
(3) Use of phosphate binding antacids
(4) During parenteral nutrition with inadequate replacement
132
How is Hypophosphatemia manifested?
(1) CNS depression
(2) Confusion
(3) Muscle weakness and pain
(4) Dysrhythmias
(5) Cardiomyopathy
133
This is the coenzyme in metabolism of proteins and carbohydrates, which is affected by the regulation of calcium balance.
Magnesium
134
This is the most abundant intracellular fluid cation next to potassium.
Magnesium
135
How is magnesium absorbed and excreted>
Absorbed from small distal bowel and excreted via the kidneys
136
How many magnesium is bounded to protein albumin and is contained in the bone respectively?
1/3; 50% to 60%
137
What is the relationship between potassium and magnesium?
directly related (proportional)
138
What is the normal level of magnesium?
1.3 to 2.3 or 3 mEq/L
139
What is the function of magnesium?
(1) It acts directly on myoneural junction (muscle nerves)
(2) Mg imbalance affect neuromuscular irritability and
contractility. Mg produces a sedative effect at the neuromuscular junction.
(4) Affects cardiovascular system – peripheral vasodilation of
arteries and arterioles.
140
This condition pertains to high levels of magnesium (Mg).
hypermagnesemia
141
What causes hypermagnesemia?
(1) Kidney failure
(2) Untreated Diabetic ketoacidosis (DKA) (catabolic state release cellular Mg)
(3) Addison’s disease, Adrenocorticotropic hormone (ACTH)insufficiency
(4) Excess intake – over replacement IV, oral intake of Mylanta and antacids with Mg as well as Lithium intoxication
142
How is hypermagnesemia?
(1) Hyporeflexia of DTR, muscle weakness or paralysis
(2) Depressed Respiratory Rate (Mg = 10 mEq/L)
(3) Cardiac arrest
(4) Blood- platelet clumping due delayed thrombin
formation
(5) Low BP (peripheral vasodilation)
(6) Facial flushing, sensation of warmth
(7) Lethargy, difficulty speaking (dysarthria)
143
This condition pertains to low levels of magnesium (Mg).
Hypomagnesemia
144
What causes hypomagnesemia?
(1) Prolonged fasting or starvation
(2) Chronic alcoholism
(3) Fluid loss from gastrointestinal tract
(4) Prolonged parenteral nutrition without supplementation and deficient enteral therapy
(5) Diuretics' ( Administration of aminoglycosides, cyclosporine, cisplatin, amphotericin, Diabetic ketoacidosis (DKA)
(6) Ethyl Alcohol Withdrawal
(7) Inflammatory Bowel Disease
(8)Sepsis, Burns and hypothermia
145
How is hypomagnesemia manifested?
(1) Confusion
(2) Hyperactive deep tendon reflexes
(3) Tremors
(4) Seizures
(5) Cardiac Dysrhythmias
146
This is a major ECF anion and assist in determining osmotic pressure. Moreover, it is found mainly in interstitial (IF) and lymph fluid compartments.
Chloride
147
What is normal level of chloride?
97 – 107 mEq/L
148
How does Na and Cl changes affect osmolality or dilution?
Na and Cl reflects change in osmolality
and/or dilution or concentration level
of ECF
149
Where is chloride produced?
(1) produced by the stomach where it combines with
H ion to form HCl
(2) Can also contained in pancreatic juices, sweat, saliva,
bile
150
What is the relationship between Bicarbonate (HCO3) and Chloride?
Inverse Relationship
151
How does Biocarbonate assist acid-base balance?
Chloride shift as CL moves from the plasma into red blood cells, bicarbonate moves back to the plasma to assist acid-base balance.
152
This occurs with hypernatremia and the loss of bicarbonate (HCO3) in the kidneys or gastrointestinal tract.
Hyperchloremia
153
What causes hyperchloremia?
(1) Near Drowning (swimming pool)
(2) Hyperchloremic metabolic acidosis
(3) Head trauma
(4) Profuse perspiration and decreases glomerular filtration
(5) Excess Adrenocorticotropic hormone (ACTH) production
154
How is hyperchloremia manifested?
(1) Same as metabolic acidosis and hypernatremia or hypervolemia
(2) Tachypnea, weakness, lethargy, deep rapid respirations; cognitive ability declines
(3) Could lead to dysrhythmias decreased cardiac output and coma
(elevated Cl accompanies high Na level)
155
This condition pertains to low levels of chlorine and parallels Sodium level, thus resulting to water excess.
Hypochloremia
156
What causes hypochloremia?
(1) Metabolic alkalosis (elevated pH and high serum bicarbonate (HCO3)
(2) Excessive Vomiting
(3) Low Salt Intake
(4) Drug interaction with Aldosterone, ACTH, bicarb replacement
(5) Volume depletion- Na and HCO3 are retained by the kidneys to balance the loss; HCO3 accumulates and leads to hyperchloremic metabolic alkalosis
157
These are weak bonds that forms a “bridge” between Nitrogen or Oxygen atom and another electron-hungry atom (common between water molecules)
Hydrogen
158
How is hydrogen important?
Formation of fragile bonds important to maintain structure of protein molecules and Foundation of body building materials.
159
This is sour in taste and usually burns. This substances can release H ions in detectable amounts
Acids
160
Acids are also known as "__________________"
Proton donors
161
This is typically bitter in taste and feels slippery to touch. Hydroxide is the most common example of this.
Base
162
Bases are also known '____________________"
Proton acceptors
163
This form of acid-base balance prevents major change in pH by removing or releasing H ion.
Buffer Systems (Kidney)
164
An increase in H ion leads to ___________. (excessive hydrogen ions)
acidity (lower than 7.35)
165
An decrease in H ion leads to ___________. (deficient hydrogen ions)
alkalinity (higher than 7.45)
166
This indicates the Indicates the hydrogen ion concentration in the blood. Moreover, it determines the overall state of acid-base balance but does not indicate source
pH
167
What kind of relationship does pH and hydrogen have?
inverse relationship
168
What are the extracellular buffer systems?
(1) Bicarbonate (HCO3) [alkaline, kidney] – carbonic acid (H2CO3) [lungs]
(2) Monohydrogen-dihydrogen phosphate
(3) Intracellular Proteins
(4) Plasma proteins
(5) RBC’s and hemoglobin
169
What are the different fixed acids in the ph negative logarithm?
(1) Sulfuric acid
(2) Phosphoric Acid
(3) Keto acid
(4) Lactic Acid
170
These fixed acids are produced by protein metabolism
(1) Sulfuric acid
(2) Phosphoric Acid
171
These fixed acids are produced by incomplete lipid metabolism (observed usually in diabetic patients)
Keto acid
172
These fixed acids are produced by anaerobic CHO metabolism (observed primarily in patients in shock)
Lactic Acid
173
What are the three principle buffer systems in the kidney tubular fluid?
(1) Bicarbonate (HCO3)
(2) Ammonia (NH3)
(3) Phosphate (PO4)
174
This principal buffer is generated from from hydrolysis reaction, CO2 is reabsorbed into the blood for excretion by the lungs and H2O to be eliminated by the kidneys
Bicarbonate (HCO3)
175
This principal buffer combines with H to form the non-reabsorb able NH4 and/or combines with Chloride. This is usually seen in patients who have damaged lungs.
Ammonia (NH3)
176
This principal buffer is formed when Na2HPO4 present in the filtrate, exchanges H ion for Na; H2PO4 is excreted in the urine whereas Na and HCO3 enter the blood
Phosphate (PO4)
177
Explain the process of carbonic-bicarbonate buffer system
This process neutralizes HCl to prevent changes in blood pH. This occurs when Na (strong acid) binds with sodium hydrogen bicarbonate (NaH2CO3 - weak acid) to form NaCl (salt) and H2CO3 (carbonic acid - weak acid).
178
Explain the process of hydrolysis reaction equation.
This process occurs when H2CO3 (carbonic acid) is disintegrated in order to generate water (H2O) and carbon dioxide (CO2)
179
What is the ration of CO2 to HCO3 in normal acid base regulation?
1:20
180
What is ph near death or indicating death in ph level in terms of acidosis and alkalosis respectively?
6.8 and 7.8 respectively
181
How does the lungs act as a buffer system?
Respiratory system: Eliminates CO2
* Respiratory center in medulla controls breathing.
* Increased respirations lead to increased CO2 elimination
and decreased CO2 in blood
182
How fast does the respiratory system respond?
Responds within minutes/hours to changes in acid/base.
183
How does the kidneys act as a buffer system?
* Renal system: Eliminates H+ and reabsorbs HCO3
-Reabsorption and secretion of electrolytes
(e.g., Na+, Cl-)
184
How fast does the renal system respond?
Responds within hours to days
185
These occur when compensatory mechanisms fail.
Imbalances
186
These imbalances affect carbonic acid concentration
Respiratory imbalances
187
These imbalances affect bicarbonate concentration
Metabolic imbalances
188
Where is blood drawn for Arterial blood gas (ABG) interpretation in adults?
Radial Artery
189
Where is blood drawn for Arterial blood gas (ABG) interpretation in children?
Femoral Artery
190
What kind of information does the Arterial blood gas (ABG) values provide?
(1) Acid-base status
(2) Underlying cause of imbalance
(3) Body’s ability to regulate pH
(4) Overall oxygen status
191
This condition in Arterial blood gas (ABG) pertains to carbonic acid excess.
Respiratory Acidosis
192
What causes respiratory acidosis?
Hypoventilation and Respiratory Failure
193
How is respiratory acidosis compensated?
Kidneys conserve HCO3 (bicarbonate) and secrete H+ into urine
194
This condition in Arterial blood gas (ABG) pertains to carbonic acid deficit.
Respiratory Alkalosis
195
What causes respiratory alkalosis?
Hyperventilation and Hypoxemia from acute pulmonary disorders
196
How is respiratory alkalosis compensated?
Rarely occurs because of aggressive treatment of
causes of hypoxemia
197
This condition pertains to base bicarbonate deficit.
Metabolic Acidosis
198
What causes metabolic acidosis?
(1) Ketoacidosis
(2) Lactic acid accumulation (shock)
(3) Severe diarrhea
(4) Kidney disease
199
This condition pertains to base carbonate excess.
Metabolic Alkalosis
200
What causes metabolic alkalosis?
(1) Prolonged vomiting
(2) Gain of HCO3
