NUR 118 - Week 11 - Chemical Regulation/ABG

Question 1

List 3 ways the body maintains its acid base balance​

Answer 1

1) Buffers – first line of defense - Blood & Tissue fluid​

Carbonic acid-sodium bicarbonate buffer 90% of metabolic processes in ECF​

Phosphate - regulate in ICF​

Protein system buffers intracellular fluid and plasma ​

2) Respiratory control of carbon dioxide PaCO2 (LUNGS = CO2)​

3) Renal control of bicarbonate HCO3 (KIDNEY EXCRETES OR HOLDS BICARB)

Question 2

Interpretation of arterial blood gases (ABG’s)​
-Know normal values of pH, PaCO2, HCO3​

MUST KNOW

Answer 2

pH = 7.35 – 7.45​
PaCO2 = 35 – 45​
- CO2 = acidic
- >45 = acidic
- <35 = alkaline
HCO3 = 22 – 26
- HCO3 = Alkaline
- >26 = Alkaline
- <22 = Acidosis

Question 3

Analyze ABG’s for the following 4 conditions: ​

-respiratory acidosis
-respiratory alkalosis
-metabolic acidosis
-metabolic alkalosis​

Question 4

Think: Alkalosis = Low CO2 = Hyperventilation (anxiety d/t exam)

Question 5

What is the relationship between respiratory and Acid-Base Balance

Answer 5

Hyperventilation:
CO2 (acidic) is blown off = Respiratory Alkalosis

Hypoventilation:
CO2 (Acidic) is NOT being blown off = Respiratory Acidosis

Question 6

What are respiratory issues that can effect Acid-Base Balance

Answer 6

Respiratory Acidosis:
HYPOVENTILATION​
IMPAIRED GAS EXCHANGE​
COPD ​
Drug overdose​
Alcohol intoxication
Respiratory arrest/APNEA​
Airway obstruction

Respiratory Alkalosis
-HYPERVENTILATION d/t:

Panic​
Anxiety​
Sepsis/Fever​
Pain​
DKA​
Hypokalemia (release of potassium)

Question 7

Patients with renal/kidney disease are in acidosis or alkalosis?
How?

Answer 7

Pts hold onto electrolytes and fluid which leads to metabolic acidosis

Question 8

Patients who are vomiting are in acidosis or alkalosis?
How?

Answer 8

Leads to metabolic alkalosis
- Patient is vomiting acid

Question 9

Patients with diarrhea are in acidosis or alkalosis?
How?

Answer 9

Metabolic acidosis
- HCO3 is released in stool

Question 10

Metabolic Acidosis:
Causes
s/s
Treatment

Answer 10

Cause:
Renal Failure
Diarrhea = loss of HCO3
Uncontrolled diabetes

s/s:
Kussmaul Breathing
Headache
Confusion
Weakness

Treatment:
Bicarbonate
Treat cause

Question 11

Metabolic Alkalosis:
Causes
s/s
Treatment:

Answer 11

Cause:
Renal failure
GI issues r/t loss of gastric secretion
- Vomiting
- Gastric Suction
- Diuretics

s/s:
Hypertonic Muscles
Hypoventilation
Dizziness

Treatment:
Antiemetics
K+ Replacement

Question 12

Furosemide r/t Acid-Base Balance

Side effects

Answer 12

Hypokalemia (Low Potassium)
- Metabolic Alkalosis