Test 2 Acid and Base Flashcards

1
Q

pH

A

derivative logarithmic expression of the hydrogen ion concentration; a measure of alkalosis and acidosis

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2
Q

CO2

A
  • abbreviation for bicarbonate measured in BMP

- used in anion gap calculation

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3
Q

PaCO2

A

measure of the partial pressure of CO2 in the arterial blood is reflective of minute ventilation

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4
Q

HCO3

A
  • measure of the presence of base in the blood

- measured via ABG to assess blood gas disorders

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5
Q

BE

A
  • base excess
  • indicates alkalosis
  • excess in the amount of base present in the blood
  • measured in mEq/L
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6
Q

BD

A
  • base deficit
  • indicates acidosis
  • deficit in the amount of base present in the blood
  • measured in mEq/L
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7
Q

Acidemia

A

pH < 7.35

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8
Q

Alkalemia

A

pH > 7.45

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9
Q

Respiratory acidosis: pH, disturbance, compensation

A
  • pH: decreased
  • disturbance: ↑ PaCO2
  • compensation: ↑ HCO3 in kidney; lose Cl → maintain bicarb
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10
Q

Metabolic acidosis: pH, disturbance, compensation

A
  • pH: decreased
  • disturbance: ↓ HCO3
  • compensation: ↓ PaCO2 by hyperventilating
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11
Q

Respiratory alkalosis: pH, disturbance, compensation

A
  • pH: increased
  • disturbance: ↓ PaCO2
  • compensation: ↓ HCO3
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12
Q

Metabolic alkalosis: pH, disturbance, compensation

A
  • pH: increased
  • disturbance: ↑ HCO3
  • compensation: ↑ PaCO2 by slowing down breathing rate
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13
Q

anion gap formula

A
  • [Na+] – [Cl-] – [CO2]

* CO2 represents bicarb from serum blood

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14
Q

ab/normal anion gap value/s

A
  • normal: <= 11 mEq/L

* elevated: > 11 mEq/L → acidosis

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15
Q

normal values of pH

A

7.40 (7.35-7.45)

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16
Q

normal values of PaCO2

A

35-45 mm Hg

17
Q

normal values of HCO3

A

24 mEq/L or mmol/L (22-26)

18
Q

PaCO2 effect on pH

A

↑ 10 mmHg from 40 mmHg = ↓ pH 0.08

19
Q

↑ minute ventilation

A

↑ PaCO2 excretion and ↓ PaCO2 in blood

20
Q

↓ minute ventilation

A

↓ CO2 excretion and ↑ PaCO2 in blood

21
Q

CA = Carbonic Anhydrase

A

helps with build up and break down of carbonic acid

22
Q

K an anion gap: acidosis

A
  • K shifts outside of cell

- hyperkalemia

23
Q

K an anion gap: alkalosis

A
  • K shifts inside of cell
  • hypokalemia
  • bicarb shifts K back into the cell
24
Q

arrangement of ABG

A

pH / PaCO2 / HCO3 / PaO2 / BE or BD

25
Q

Compensatory response of metabolic acidosis

A

PaCO2 should ↓ by 1.3 times the fall in HCO3-

26
Q

Compensatory response of metabolic alkalosis

A

PaCO2 should ↑ by 0.6 times rise in HCO3-

27
Q

Metabolic acidosis compensatory response formula

A

40 – [(1.3) x (24- Pts’ bicarb on ABG)]

28
Q

Metabolic alkalosis compensatory response formula

A

40 + [(0.6) x (Pts’ bicarb on ABG-24)]

29
Q

etiologies of metabolic acidosis

A
  • Methanol ingestion
  • Urea (i.e., acute or chronic renal failure)
  • Diabetic ketoacidosis
  • Paraldehyde
  • Isoniazid, ischemia (i.e., lactic acidosis)
  • Lactic acid (e.g., metformin, linezolid, propofol, pentobarbital, lorazepam, phenobarbital)
  • Ethylene glycol ingestion
  • Salicylates, starvation
  • For anion gaps <= 11, could be caused by diarrhea, being on CaCl, rapid correction with acidic IV fluids
30
Q

Plasmalyte A pH

A

7.4

31
Q

NS pH

A

5.5

32
Q

LR pH

A

6.5

33
Q

D5W pH

A

5.0

34
Q

Etiologies of metabolic acidosis

A
  • GI disorders
  • Diuretic therapy: furosemide, bumetanide, torsemide, hydrochlorothiazide, chlorothiazide
  • Mild/moderate potassium deficiency
  • Excessive bicarbonate therapy
  • Correction of chronic hypercapnia
  • Cystic fibrosis
35
Q

etiologies of respiratory acidosis

A
  • Medications (e.g., sedatives, opioids)
  • Stroke/head injury
  • Asthma
  • COPD
  • Brainstem/cervical cord injury
  • TPN
36
Q

etiologies of respiratory alkalosis

A
  • anxiety
  • pain
  • high altitude
  • severe anemia