Test2 Acid Base Balance Flashcards
This is metabolism equilibrium it adjusts the body to maintain a stable balance
Homeostasis
The body needs balance Between acids and Alkali
These are natural and normal chemicals in the body
Acid base
Water is ph neutral at a level of what?
7.0
Normal arterial blood pH is what?
Alkaline or acidosis
7.35-7.45
Alkaline
Too much alkalinity or acidity can damage what in the body?
Body tissues
The lower the pH the more corrosive the what?
What levels ?
Acid
Ph - 1-6
The higher the pH, the more corrosive the what?
What level ph ?
Base
8-14
Can be damaging in excess
essential to homeostasis in the body
Naturally occurring
Essential for life
Acid and bases
How does the body protect itself from damage related to acid-base balance?
Regulatory systems such as respiratory system, kidneys, chemical buffers which change the pH
What is the primary buffer?
Kidneys (renal system)
This organ excrete or retains acids and bases to buffer changes in pH
It controls bicarbonate (a base) HC03- This is a very slow process
Kidneys
This organ controls the excretion of carbon dioxide CO2 – a mild acid called carbonic acid in the blood.
How fast can this occur in the body?
Lungs
Within minutes – rapidly
Blowing out the CO2 makes blood more what?
Example?
Less Co2 means what?
Alkaline it basic
Hyperventilation or fast breathing
Less acid ( high ph) (more alkaline )
Retaining CO2 makes blood more what?
Example?
Acidic (lower ph)
Slow breathing /hypoventilation
What happens when the kidneys retain plasma bicarbonate (hco3)
Neutralizes acid and blood becomes more alkaline (increases ph)
What happens when the kidneys excrete or get rid of bicarbonate (hco3)
The blood becomes more acidic (decrease ph)
What do ABGs test for?
Arterial blood gas
Ph Bicarbonates (HCO3) Pa CO2 HCO3 BE (base excess)
What is the pH balance of acidosis?
Less than 7.35
What is the pH balance of alkalosis?
Greater than 7.45
What are the common causes of acidosis?
Body creates too much acid or loss of base
D’s
Diabetes
Dysfunctional kidneys/dialysis
Diarrhea (or any loss through intestines )
How many causes of alkalosis?
Which is too much bicarbonate/base taken in or loss of too much acid
Oral or IV intake of substances that increase pH level (antacids , IV solutions )
Loss of acidic gastric secretion such as vomiting, suctioning
Respiratory common causes of acidosis?
Think A and B of abcs
Anything that reduces the exchange of oxygen and CO2 output
Airway obstruction Difficulty breathing (pneumonia, pulmonary edema, narcotics, ventilator set low)
Common causes of respiratory alkalosis?
In this case the airway is not the problem
-Always relates to rapid breathing
Fear/anxiety
Fever
Ventilator set too high
When the problem is metabolism the lungs will try to respond to how? Because the kidneys are what?
This means changes in what may clue you that there is an imbalance ?
Quickly
Slow
Respiratory patterns
Normal values of ABGs:
Ph:
CO2:
O2:
HCO3:
Ph- 3.5-4.5
CO2-35-45
11-1
Ph. 225 and 11-2
If CO2 is low then what else will be low?
Carbonic acid
What should you do for a patient that is hyperventilating?
Calm the patient
Have the pt breath into a paper bag
Give anti- anxiety medication if needed
If patient is on a ventilator- slow the rate
What can you do with the nurse to help prevent tissue damage?
Constantly monitor for changes and respond to any Abnormal findings
(electrolytes, fluids, and acid base balance)
What creates equilibrium in the body? And in balance in how many of these may affect the balance of the others?
What your lights, fluids, and acid-base balance
Any
Certain body disorders such as what can cause and balances with electrolytes fluids and acid-base?
Endocrine and Renal body disorders
What electrolytes are intracellular?
Potassium
Magnesium
Sulfate and phosphate
What does potassium and magnesium control in the body?
Heart muscles and neuromuscular control
If potassium is out of range what Changes should you look for in the body?
3.5 to 5.0 normal
Watch for changes in muscle strength and cardiac dysrhythmias
What electrolytes are extracellular?
Sodium
Chloride
Calcium
Bicarbonate (HCO3)
What does sodium control in the body?
Is the normal range
What to worry about if it is out of range?
Fluid balance
Neurological
135-145
Neuromuscular weakness, but mostly seizures**
These are the major diagnostic tool for evaluate an acid-base balance
Arterial blood gases
The balance of acid-base depends on what?
Regulation of free hydrogen ions
Concentration of hydrogen ions Is measured in ? What
Ph
Arterial blood gases and values
Ph (potential hydrogen )
PaCO2 (carbon dioxide)
HCO3 (bicarbonates)
7.35-7.45
35-45
22-26
Three systems That come into play when pH rises or falls?
Chemical buffers
Respiratory system
Kidneys
These combine with acid or base to neutralize harmful effects until another system takes over?
Chemical buffers
What are the three chemical buffers?
Bicarbonate, phosphate, and protein buffers
These buffers are mainly responsible for offering blood and interstitial fluid
Bicarbonate buffers
This is the buffer effective in renal tubule’s
Phosphate buffer
This buffer is most plentiful – hemoglobin
Protein buffer
Regulate blood levels of CO2
Lungs
What is twice as effective as chemical buffers but Effects are temporary?
Respiratory system
This organ re-absorbs or excrete excess acids or bases into urine. It also produces bicarbonate
Kidneys
Adjustments by the kidneys take how long to accomplish?
Bicarbonate in pH levels of just how together?
Take hours to days to accomplish
Increase or decrease together
Arterial blood gases Uses blood from where?
An arterial puncture
What are the three steps to interpreting ABGs?
1- check the pH
(Is it acidosis or alkadosis)
2-what is the CO2
3-Watch the bicarb
A high pH expects what CO2?
A low pH expects what CO2?
Low co2 in blood (hypercapnia)
High co2 retention (hypercapnia)
If ph is high, bicarb expected to be ?
If ph is low, bicarb expected to be ?
High (metabolic alkalosis)
Low (metabolic acidosis)
What are the different types of acid-base imbalances?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Any compromise and breathing such as hypoventilation (co2 build up and ph drop) can result in what?
Can be caused from what?
Respiratory acidosis
Neuromuscular trouble
Clients that just had abdominal surgery, mechanical ventilation, narcotics or sedation are at risk for what?
Respiratory acidosis
What symptoms do you see what someone with respiratory acidosis?
Diaphoresis (sweating) , Dyspnea, tachycardia, nausea, vomiting, warm flesh skin, decreased DTR, confusion, tremors, apprehension, restlessness
What to do for someone that has respiratory acidosis?
Correct the underlying cause
Bronchodilators
Oxygen
*treat hyperkalemia
Antibiotics for infection
Chest PT to remove secretions
Remove foreign body obstruction
Just commonly results from hyper ventilation caused by pain , salicylate poisoning ,nicotine
Respiratory alkalosis
What do you see in somebody that has respiratory alkalosis?
Anxiety, restlessness, sweating, dyspnea, EKG changes, hyperreflexia, numbness, tachycardia, tetany (muscle spasms)
What to do for somebodyWith respiratory alkalosis?
Correct underlying disorder, oxygen therapy for Hypoxemia, sedatives or anti anxiety agents, paper bag breathing for hyperventilation
This is characterized by a gain of acid or loss of bicarb
And is associated with ketone bodies (Diabetes, alcoholism, starvation, hyperthyroidism)
Heart failure, pulmonary disease, seizures, strenuous exercise, hepatic disease
Metabolic acidosis
What do you see with someone with metallic acidosis?
Confusion, headache, decrease DTRs,
hyperkalemia, (ab cramps, diarrhea, muscle weakness, ekg changes)
hypertension, Kussmals respirations, Lethargy, warm and dry skin
What to do for someone with Matab look acidosis?
Regular insulin to reverse DKA or keto acidosis
Iv bicarb to correct acidosis
Fluid replacement
Dialysis for drug toxicity
Antidiarrheals
This is commonly associated with hypokalemia from diuretic use, Hypochloremia and hypocalcemia
It is also caused by excessive vomiting, and G section, can you disease, crushings disease or drugs containing baking soda
Metabolic alkalosis
What does somebody that has metallic alkalosis experience? Symptoms?
Anorexia , cyanosis, Polyuria (increased urination)
Apathy (lack of interests)
Hypotension, reflective, muscle twitching, nausea, numbing, vomiting, weakness
What to do for somebody with metabolic alkalosis ?
IV ammonium chloride
Continue diuretics and NG suctioning
Antiemetics- to stop vomiting
