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Nur 336 > Respiratory - Unit 3 - Acid/Base Imbalances > Flashcards

Respiratory - Unit 3 - Acid/Base Imbalances Flashcards

1
Q 
pH = 
CO2 =
PaCO2 = 
O2 = 
PaO2 = 
HCO3 =
A 
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
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2
Q

What are some buffers against H+?

A

Bicarbonate (HCO3), Phosphorus (H3PO4), Protein (Hemoglobin)

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3
Q

Hyperventilate = PCO2 = __ & ___.

Hypoventilate = PCO2 = ___ & ___.

CHANGES OCCUR IN ???

A

Lost & alkaline.

Retained & acid.

MINUTES!!!

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4
Q

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

A

Decreased.

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5
Q

With excessive base formation, the respiratory rate slows to promote ___ levels of CO2.

A

Increased

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6
Q

If the RESPIRATORY system is the source of the pH problem, it loses the ability to correct the problem. T/F?

A

True!

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7
Q

HCO3 Reabsorbed = ?

A

Alkaline

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8
Q

HCO3 Excreted = ?

A

Acid

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9
Q

Changes for renal occur in ???

A

Hours!

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10
Q

In acidosis, H+ is excreted in the kidney before K+ions causing ___kalemia.

A

Hyperkalemia.

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11
Q

In alkalosis (decreased H+), H+ is retained and K+ ions are excreted causing _____kalemia.

A

Hypokalemia.

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12
Q

If the renal system is the cause of the pH problem, it loses it’s ability to correct the problem. T/F?

A

True!

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13
Q

What are some ABG Arterial Sites?

A

Brachial, radial (art line/common), femoral (art line) - GREATEST CHANCE OF HEMORRHAGE HERE

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14
Q

What is the ALLEN test?

A

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!

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15
Q

What is the normal pH range?

A

7.35-7.45

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16
Q

Increased pH = ?

Decreased pH = ?

A 
Increased = Alkalotic
Decreased = Acidotic
17
Q

pH of 6.8-7.8 is INCOMPATIBLE with life. T/F?

A

False - it is compatible but probably means they won’t make it.. :(

18
Q

PCO2 Normal =
HCO3 Normal =
PO2 Normal =
O2 Sat Normal =

A

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)

19
Q

What occurs in metabolic alkalosis?

A

Increased pH, increased HCO3

20
Q

What happens in metabolic acidosis?

A

Decreased pH, decreased HCO3

21
Q

If acidic, increased PCO2 =, decreased HC03 =

A

Increased PC02 = respiratory

Decreased HCO3 = Metabolic

22
Q

If alkaline, decreased PCO2 =, decreased HCO3 =

A

Decreased PCO2 = Respiratory

Decreased HCO3 = Metabolic

23
Q

If the results are borderline, we know what they are by leaning. T/F?

A

True - like if it’s 7.35, it’s LEANING towards acid.

If it’s 7.45, it’s leaning toward alkalosis!

24
Q

Decreased O2 sat = Acid or alkalosis?

Decreased PO2 = Acid or alkalosis.

A

Both acid!

25
Q

What is a primary acid/base disorder?

A

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)

26
Q

What is a MIXED acid/base disorder?

A

Number of combinations of respiratory & metabolic disturbances - disturbance in one part of the system is intensified by superimposed disorder.

27
Q

With respiratory acidosis, what are some hypoventilation disorders that might cause it?

A

COPD, Obstructed airway, pulmonary edema, pneumonia, head injuries/strokes, hemothorax, cardio-pulmonary arrest, drug overdose, etc.

28
Q

What are some symptoms of respiratory acidosis?

A

Respirations slow and ineffective, tachy/irregular pulse, restlessness/confusion, SOB w/exertion, headache, paralysis, tremors, arrhythmia’s, N/V, cyanosis, increased ICP/coma.

29
Q

How do we treat respiratory acidosis?

A

CORRECT CAUSE - give fluids with IV KCL, O2 therapy, bronchodilators, chest PT, antibiotics, avoid narcotics and sedation, etc.

30
Q

Respiratory Alkalosis (decreased pCO2, increased pH) - What are some hyperventilation disorders that might cause this?

A

Fear, pain, anxiety, pneumonia, pulmonary emboli, CVA, high altitude anoxia, ASA poisoning (early), fever/septicemia, excessive CMV

31
Q

What are some respiratory alkalosis symptoms?

A

RAPID RESPIRATIONS, hyperreflexia, tingling in fingers and toes, irregular pulse/respirations, lightheadedness, dyspnea, anxiety/panic, convulsions.

32
Q

What are some treatment options for respiratory alkalosis?

A

Correct cause!, rebreathe CO2, decrease activity, sedatives, decadron (steroid), diuresis, CMV

33
Q

What are some dehydration disorders that cause Metabolic Acidosis (Decreased bicarb, decreased pH)

A

DIABETES (Ketoacidosis), shock, severe diarrhea, GI Suction, systemic infections, pancreatitis, HA/Saline IV, Renal failure.

34
Q

What are some metabolic acidosis symptoms?

A

KUSSMAUL respirations (deep and labored), headache w/restlessness, apathy/depression, hypotensions, warm & flushed skin, weakness, abd. pain, N/V/Anorexia

35
Q

How do we treat Metabolic Acidosis?

A

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.

36
Q

Metabolic Alkalosis (Increased HCO3, Increased pH) - what causes it?

A

Reduced K+, by things like GI Suction, vomiting, diuretics, prolonged steroid therapy, excessive bicarb intake

37
Q

What are some Metabolic Alkalosis Symptoms?

A

CNS Excitability, Slow/Shallow respirations, irregular/tachy pulse, hypotension, numbness, tetany —> convulsions, lethargy/weakness, disorientation

38
Q

How do we treat Metabolic Alkalosis?

A

CORRECT CAUSE, NaCl & KCL IV Replacement, Acidifying Meds –> Acidifying Salts, Hydrochloride

Nur 336 (26 decks)

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