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Respiratory II > Respiratory Acidosis and Alkalosis > Flashcards

Respiratory Acidosis and Alkalosis Flashcards

1
Q

pH Equation

A

pH = 6.1 + log HCO3/(0.03*pCO2)

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2
Q

Respiratory Acidosis and Alkalosis

A

Respiratory Acidosis and Alkalosis

  • pH = 6.1 + log HCO3/pCO2
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3
Q

Metabolic compensation to respiratory alkalosis and acidosis:

A

Metabolic compensation to respiratory alkalosis and acidosis:

the kidneys slowly alter the HCO3 in an attempt to return the pH to normal.

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4
Q

Rules for acid base disturbances

A

Rules for acid base disturbances

Check pH for alkalosis or acidosis

  1. Is it metabolic or respiratory?
  2. Calculate anion gap
  3. Is compensation appropriate? (Calculations listed on the next slide) If not it is a mixed disorder.

5. What clinical condition is present that will explain the blood gas changes?

6. A sole primary disorder with normal compensation will never correct back to normal pH of 7.40.

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5
Q

Compensation Equations

Metabolic Acidosis

A

Compensation Equations

Metabolic Acidosis → (delta)pCO2 = 1.2 X DHCO3

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6
Q

Compensation Equations

Metabolic Alkalosis

A

Compensation Equations

Metabolic Alkalosis → (delta)pCO2 = 0.7 X DHCO3

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7
Q

Compensation Equations

Acute Respiratory Acidosis

A

Compensation Equations

Acute Respiratory Acidosis →

(delta)HCO3 = 0.1 X (delta)pCO2

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8
Q

Compensation Equations

Chronic Respiratory Acidosis

A

Compensation Equations

Chronic Respiratory Acidosis →

(delta)HCO3 = 0.4 X (delta)pCO2

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9
Q

Compensation Equations

Acute Respiratory Alkalosis

A

Compensation Equations

Acute Respiratory Alkalosis →

(delta)HCO3 = 0.2 X (delta)pCO2

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10
Q

Compensation Equations

Chronic Respiratory Alkalosis

A

Compensation Equations

Chronic Respiratory Alkalosis →

(delta)HCO3 = 0.5 X (delta)pCO2

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11
Q

A 48 y/o male with cirrhosis of the liver is brought to the ER after ingesting 30 ASA tablets in a suicide attempt. Temperature is 38.8 C (102 F) with pulse of 100. Respirations are 28 breaths/min. He has ascites, peripheral edema, and carpopedal spasms. Sodium is 120 meq/L, BUN is 60 mg/dL with creatinine is 2 mg/dL. Glucose is 60 mg/dL. A blood gas is drawn and shows:

pH = 7.60 – acidosis or alkalosis?

HCO3 = 21 meq/L

pCO2 = 20 mmHg

What is this acid base problem called?

(on top of the fact that this dude puts the DUH in “Big Huge Attention Grabbing Dumb Butt”)

A

pH = 7.60 – acidosis or alkalosis?

ALKALOSIS

What is this acid base problem called?

Uncompensated Acute Respiratory Alkalosis

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12
Q

Uncompensated Acute Respiratory Alkalosis

or as represented by a chart

A
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13
Q

A 48 y/o male with cirrhosis of the liver is brought to the ER after ingesting 30 ASA tablets in a suicide attempt. Temperature is 38.8 C (102 F) with pulse of 100. Respirations are 28 breaths/min. He has ascites, peripheral edema, and carpopedal spasms. Sodium is 120 meq/L, BUN is 60 mg/dL with creatinine is 2 mg/dL. Glucose is 60 mg/dL. A blood gas is drawn and shows:

pH = 7.60

HCO3 = 21 meq/L

pCO2 = 20 mmHg

If the respiratory alkalosis were to continue for 2-3 days?

A

If the respiratory alkalosis were to continue for 2-3 days, the kidneys will compensate by Excreting HCO3:

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14
Q

If the respiratory alkalosis were to continue for 2-3 days?

Useless Stupid @$$ chart format

A
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15
Q

Causes of Respiratory Alkalosis

A

Causes of Respiratory Alkalosis

  1. SIRS
  2. Hypoxia
  3. Cirrhosis
  4. Pregnancy
  5. ASA poisoning
  6. Anxiety-Hyperventilation
  7. Cerebral hemorrhage or thrombosis
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16
Q

A 34 y/o male is involved in a MVA and suffers fractured ribs. He is seen in the ER and blood gases show:

  • pH = 7.22
  • pCO2 = 70 mmHg
  • HCO3 = 28

What is this acid base problem called?

(no its not called sux to be this guy)

A

Uncompensated Respiratory Acidosis

17
Q
A
18
Q

A 34 y/o male is involved in a MVA and suffers fractured ribs. He is seen in the ER and blood gases show:

pH = 7.22

pCO2 = 70 mmHg

HCO3 = 28

Uncompensated Respiratory Acidosis

(Retard Chart Format)

A

Uncompensated Respiratory Acidosis

(Retard Chart Format)

19
Q

Compensated Respiratory Acidosis

A

Compensated Respiratory Acidosis

20
Q

Compensated Respiratory Acidosis

(again with the frig’n chart)

A

Compensated Respiratory Acidosis

(again with the frig’n chart)

21
Q

A “blue bloater” (aka sexy beast) from the local nursing home comes into your office for his 3 month check up. Your nurse applies O2 due to his cyanosis and he becomes somolent, confused and manifest asterixis. Physical exam shows papilledema.

Blood gas is drawn showing:

  • pH = 7.24
  • pCO2 = 90 mmHg
  • pO2 = 40 mmHg

Electrolytes show as:

Na - 140 meq/L

K - 4.02 meq/L

Cl - 93 meq/L

HCO3 - 39meq/L

What has happened?

(aside from the fact that all the women in your office lost their minds because homie took his shirt off and they couldn’t handle the industrial strength sexy)

A

Primary Respiratory Acidosis with compensation and subsequent decompensation

Respiratory II (14 decks)

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