Respiratory - Unit 3 - Acid/Base Imbalances Flashcards
pH = CO2 = PaCO2 = O2 = PaO2 = HCO3 =
pH = The chemical abbreviation for negative logarithm of hydrogen ion concentration. CO2 = Carbon Dioxide PaCO2 = Pressure of dissolved CO2 O2 = Oxygen PaO2 = Pressure of dissolved oxygen. HCO3 = Bicarbonate
What are some buffers against H+?
Bicarbonate (HCO3), Phosphorus (H3PO4), Protein (Hemoglobin)
Hyperventilate = PCO2 = __ & ___.
Hypoventilate = PCO2 = ___ & ___.
CHANGES OCCUR IN ???
Lost & alkaline.
Retained & acid.
MINUTES!!!
With excessive acid formation, the respiratory center in the medulla is stimulated, which results in increased depth/rate of respirations, which leads to __ level of CO2
Decreased.
With excessive base formation, the respiratory rate slows to promote ___ levels of CO2.
Increased
If the RESPIRATORY system is the source of the pH problem, it loses the ability to correct the problem. T/F?
True!
HCO3 Reabsorbed = ?
Alkaline
HCO3 Excreted = ?
Acid
Changes for renal occur in ???
Hours!
In acidosis, H+ is excreted in the kidney before K+ions causing ___kalemia.
Hyperkalemia.
In alkalosis (decreased H+), H+ is retained and K+ ions are excreted causing _____kalemia.
Hypokalemia.
If the renal system is the cause of the pH problem, it loses it’s ability to correct the problem. T/F?
True!
What are some ABG Arterial Sites?
Brachial, radial (art line/common), femoral (art line) - GREATEST CHANCE OF HEMORRHAGE HERE
What is the ALLEN test?
shows rather patency of radial of ulnar artery is normal. You compress radial artery and ulnar artery —-> release ulnar artery and check circulation to hand.
DO NOT USE radial artery if poor circulation — could lead to loss of hand!
What is the normal pH range?
7.35-7.45
Increased pH = ?
Decreased pH = ?
Increased = Alkalotic Decreased = Acidotic
pH of 6.8-7.8 is INCOMPATIBLE with life. T/F?
False - it is compatible but probably means they won’t make it.. :(
PCO2 Normal =
HCO3 Normal =
PO2 Normal =
O2 Sat Normal =
PCO2 Normal = 35-45 (Ventilation)
HCO3 Normal = 22-26 (Renal)
PO2 Normal = 80-100 (O2 in Plasma)
O2 Sat Normal = 95-100% (Amount of O2 in Hemoglobin)
What occurs in metabolic alkalosis?
Increased pH, increased HCO3
What happens in metabolic acidosis?
Decreased pH, decreased HCO3
If acidic, increased PCO2 =, decreased HC03 =
Increased PC02 = respiratory
Decreased HCO3 = Metabolic
If alkaline, decreased PCO2 =, decreased HCO3 =
Decreased PCO2 = Respiratory
Decreased HCO3 = Metabolic
If the results are borderline, we know what they are by leaning. T/F?
True - like if it’s 7.35, it’s LEANING towards acid.
If it’s 7.45, it’s leaning toward alkalosis!
Decreased O2 sat = Acid or alkalosis?
Decreased PO2 = Acid or alkalosis.
Both acid!
What is a primary acid/base disorder?
It’s SIMPLE - due to one cause and affects only ONE part of the buffer system (compensatory changes occur in the other part of the system)
What is a MIXED acid/base disorder?
Number of combinations of respiratory & metabolic disturbances - disturbance in one part of the system is intensified by superimposed disorder.
With respiratory acidosis, what are some hypoventilation disorders that might cause it?
COPD, Obstructed airway, pulmonary edema, pneumonia, head injuries/strokes, hemothorax, cardio-pulmonary arrest, drug overdose, etc.
What are some symptoms of respiratory acidosis?
Respirations slow and ineffective, tachy/irregular pulse, restlessness/confusion, SOB w/exertion, headache, paralysis, tremors, arrhythmia’s, N/V, cyanosis, increased ICP/coma.
How do we treat respiratory acidosis?
CORRECT CAUSE - give fluids with IV KCL, O2 therapy, bronchodilators, chest PT, antibiotics, avoid narcotics and sedation, etc.
Respiratory Alkalosis (decreased pCO2, increased pH) - What are some hyperventilation disorders that might cause this?
Fear, pain, anxiety, pneumonia, pulmonary emboli, CVA, high altitude anoxia, ASA poisoning (early), fever/septicemia, excessive CMV
What are some respiratory alkalosis symptoms?
RAPID RESPIRATIONS, hyperreflexia, tingling in fingers and toes, irregular pulse/respirations, lightheadedness, dyspnea, anxiety/panic, convulsions.
What are some treatment options for respiratory alkalosis?
Correct cause!, rebreathe CO2, decrease activity, sedatives, decadron (steroid), diuresis, CMV
What are some dehydration disorders that cause Metabolic Acidosis (Decreased bicarb, decreased pH)
DIABETES (Ketoacidosis), shock, severe diarrhea, GI Suction, systemic infections, pancreatitis, HA/Saline IV, Renal failure.
What are some metabolic acidosis symptoms?
KUSSMAUL respirations (deep and labored), headache w/restlessness, apathy/depression, hypotensions, warm & flushed skin, weakness, abd. pain, N/V/Anorexia
How do we treat Metabolic Acidosis?
CORRECT CAUSE, IV/Oral HCO2, o2 therapy with CMV, replace insulin/K+/fluids, increase kidney function, increase isotonic fluid volume, assess loc & prevent injury, etc.
Metabolic Alkalosis (Increased HCO3, Increased pH) - what causes it?
Reduced K+, by things like GI Suction, vomiting, diuretics, prolonged steroid therapy, excessive bicarb intake
What are some Metabolic Alkalosis Symptoms?
CNS Excitability, Slow/Shallow respirations, irregular/tachy pulse, hypotension, numbness, tetany —> convulsions, lethargy/weakness, disorientation
How do we treat Metabolic Alkalosis?
CORRECT CAUSE, NaCl & KCL IV Replacement, Acidifying Meds –> Acidifying Salts, Hydrochloride
