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V - KCU - RN (T2) - OMS1 > Renal Control Of Acid/Base Balance > Flashcards

Renal Control Of Acid/Base Balance Flashcards

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NCLEX-RN® flashcards
1
Q

What are the volatile metabolic acid eliminations

A

Glucose and Fat

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2
Q

What are the fixed (kidney) elimination of acid

A

Glucose
Cystine
Phosphoprotein

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3
Q

A change of 0.3 pH down does what to the H concentration

A

Doubles or halves the H concentration

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4
Q

Define Pk

A

The ability of the buffer to accept H at a certain pH and fend off the effects of accumulating acid

Example: HCO3 - has a Pk of 6.1, which means at a Ph of 6.1, it can buffer acid to a pH of 6.1, making it a good buffer for the blood

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5
Q

What is the mechanism that allows for the RBC to excrete HCO3

A

The chloride shift

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6
Q

What happens in terms of body compensation with H and K in acidosis and alkalosis

A

Acid - H in, K out, hyperkalemia

Alkalosis - H out, K in, hypokalemia

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7
Q

Bicarb is mostly REBS where

A

PCT

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8
Q

What are the primary causes of increased H secretion to the urine

A
  1. Decrease in plasma HCO3 (blood is already acidic)
  2. Increase in PCO2
  3. Decrease in ECFV
  4. Hypokalemia (more out and more K in from correcting an alkalosis)
  5. Increase in aldosterone
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9
Q

What are the causes of decreased H secretion (blood is already acidic)

A
  1. Increase in plasma HCO3 (blood is alkalotic)
  2. Decrease in PCO2
  3. Increase in ECFV
  4. Hyperkalemia (more K out and more H in after fixing an acidosis and becoming alkalotic)

5 decrease in aldos.

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10
Q

What do the a and B cells do respectively

A

A - REBS HCO3 and secretes H

B - REBS H and secrets HCO3

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11
Q

Decreased HCO3 will cause what in terms of the anion gap

A

Increased anion gap

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12
Q

What are the causes of high anion gap metabolic acidosis

MUDPILERS

A 
Methanol 
Uremia
DKA/AKA
Paraldehyde 
Isoniazid 
Lactic acid
ETOH 
Rhabdo/Salicylates
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13
Q

What are the causes of non-anion gap acidosis

HARDUPS

A 
Hyperalimentation 
Acetazolamide 
RTA
Diarrhea 
Uretero-pelvic shunt 
Post-hypocapnia

Spironolactone - diuresis, and build up of K which causes hyperkalemia and thus increased H excretion into the blood

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14
Q

Define Type 2 RTA

A

Renal loss of HCO3 (failure to abdorb it at a-cells)

Hypokalemia

Normal anion gap

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15
Q

Define Type 1 RTA

A

Decreased excretion of H and NH4 into urine

Decreased ability to acidify urine at a-cells

Hypokalemia

Normal anion gap

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16
Q

Define Type 4 RTA

A

Hypoaldos..

Decreased secretion of NH4

Hyperkalemia which inhibits NH3 synthesis in PCT from glutamine

Normal anion gap

17
Q

RTA type 2 is usually seen in who

A

Children with fanconi’s syndrome

18
Q

What are the causes of metabolic alkalosis

CLEVER PD

A 
Contraction 
Licorice 
Endo things 
Vomiting
Excess alkali 
Refeeding alkalosis 
Post-hypercapnia

V - KCU - RN (T2) - OMS1 (5 decks)

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