Test2 Acid Base Balance Flashcards by Rachel P

This is metabolism equilibrium it adjusts the body to maintain a stable balance

Homeostasis

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The body needs balance Between acids and Alkali

These are natural and normal chemicals in the body

Acid base

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Water is ph neutral at a level of what?

7.0

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Normal arterial blood pH is what?

Alkaline or acidosis

7.35-7.45

Alkaline

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Too much alkalinity or acidity can damage what in the body?

Body tissues

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The lower the pH the more corrosive the what?

What levels ?

Acid

Ph - 1-6

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The higher the pH, the more corrosive the what?

What level ph ?

Base

8-14

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Can be damaging in excess

essential to homeostasis in the body

Naturally occurring

Essential for life

Acid and bases

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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

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What is the primary buffer?

Kidneys (renal system)

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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

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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

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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 )

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Retaining CO2 makes blood more what?

Example?

Acidic (lower ph)

Slow breathing /hypoventilation

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What happens when the kidneys retain plasma bicarbonate (hco3)

Neutralizes acid and blood becomes more alkaline (increases ph)

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What happens when the kidneys excrete or get rid of bicarbonate (hco3)

The blood becomes more acidic (decrease ph)

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What do ABGs test for?

Arterial blood gas

Ph 
Bicarbonates (HCO3)
Pa CO2
HCO3
BE (base excess)

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What is the pH balance of acidosis?

Less than 7.35

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What is the pH balance of alkalosis?

Greater than 7.45

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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 )

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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

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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)

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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

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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

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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

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