Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing 2300 (VIcky Hansen) > Unit 4 - Acid/Base > Flashcards

Unit 4 - Acid/Base Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

acid _____ hydrogen ions in solution

A

release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bases _____ hydrogen ions in solution

A

accept

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

_____ _____ determines acidity of body fluids

A

hydrogen ions (H+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how do you measure hydrogen ions

A

pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe pH as you increase H+

A

decrease pH = > acidic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe pH as you decrease H+

A

increase pH = > basic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

normal ABG pH of body fluids

A

7.35-7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

metabolic processes produce _____

A

acids

  • volatile (carbonic acid)
  • nonvolatile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3 systems that work together to maintain pH

A
  • buffer systems
  • respiratory system
  • renal system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Buffers prevent major changes in _____

A

pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe Buffer System

A
  • bind c H+ when excess acid is present

- release H+ if body fluids are too basic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Focus on _____ _____ as the main buffer

A

Bicarbonate HCO3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CO2 + H2O =

A

carbonic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 major buffer systems

A
  • Bicarbonate-Carbonic Acid
  • Phosphate
  • Protein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe Respiratory System:

  • Regulates carbonic acid by…
  • CO2 is potential acid when…
  • Increase in CO2 or H+…
A
  • Regulates carbonic acid by eliminating or retaining Co2
  • CO2 is potential acid when combined with water
  • Increase in CO2 or H+ stimulates respiratory center
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe Respiratory System with Acidosis:

  • Rate & depth of respiration
  • CO2 and Carbonic Acid
  • pH
A

retained CO2 and excess of carbonic acid

  • increasing rate and depth of respiration increase
  • eliminates CO2 and carbonic acid
  • you need to increase pH to normal range
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe Respiratory System with Alkalosis:

  • rate and depth of respiration
  • CO2
  • CO2 & H2O
  • Carbonic acid
  • pH
A

Loss of CO2 and deficient carbonic acid

  • decreases rate and depth of respiration
  • CO2 retention
  • CO2 combines with H2O
  • restores carbonic acid levels
  • pH back to normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe Renal system:

  • Long-term regulation of…
  • Kidneys eliminate…
  • Regulate _____ in ECF
  • faster or slower?
  • selectively excrete or retain _____ to…
A
  • Long-term regulation of acid-base balance
  • kidneys eliminate nonvolatile acids
  • regulate bicarbonate (HCO3) in ECF
  • slower
  • selectively excrete or retain H+ to maintain pH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is acid-base balance assessed?

A

by measuring arterial blood gasses (ABGs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

PaCO2 measures…

A

pressure of dissolved CO2 in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PAO2 measures…

A

pressure of oxygen dissolved in plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Serum HCO3 reflects…

A

regulation of acid-base balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Normal ABG Value:

PaCO2

A

35-45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Normal ABG Value:

HCO3

A

21-28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Normal ABG Value:

PaO2

A

80-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Effect on ABGs with Metabolic acidosis:

  • pH
  • HCO3
  • PaCO2
A
  • decrease pH
  • decrease HCO3
  • decrease PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Effect on ABGs with Metabolic alkalosis:

  • pH
  • HCO3
  • PaCO2
A
  • increase pH
  • increase HCO3
  • increase PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Effect on ABGs with Respiratory acidosis:

  • pH
  • HCO3
  • PaCO2
A
  • decrease pH
  • increase HCO3
  • increase PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Effect on ABGs with Respiratory alkalosis:

  • pH
  • HCO3
  • PaCO2
A
  • increase pH
  • decrease HCO3
  • decrease PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Severe acidosis (pH of 7.0 or less) depresses myocardial cantractility which leads to _____ _____ _____

A

decreased cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

acid-base imbalance also affect _____ _____

A

electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

In acidosis, _____ is retained as the kidney excretes excess hydrogen ions. Excess hydrogen ions also enter the cells, displacing _____ from the intracellular space to maintain the balance of cations and anions with cells. The effect of both processes is to _____ _____ _____ _____.

A

potassium
potassium
increase serum potassium levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Cause of metabolic acidosis

A

excess nonvolatile acids; bicarbonate deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Cause of metabolic alkalosis

A

bicarbonate excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Cause of respiratory acidosis

A

retained CO2 and excess carbonic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Cause of respiratory alkalosis

A

loss of CO2 and deficient carbonic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

T/F: Metabolic acidosis is rarely a primary disorder. It usually develops during the course of another.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

In acidosis, _____ is released from its bonds with plasma proteins, increasing the amount of ionized (free) _____ in the blood. Magnesium levels may _____ in acidosis.

A

calcium
calcium
fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Metabolic alkalosis: a client may experience numbness around the mouth and tingling of the fingers. This may be explained due to the fact that alkalosis increases binding of _____ _____ to _____ _____ _____ levels. As a result, _____ _____ increases, and manifestations similar to hypocalcemia develop. These manifestations include circumoral and distal extremity parasthesias.

A

extracellular calcium
reducing ionized calcium
neuromuscular excitability

40
Q

Compensations for metabolic acidosis

A

rate and depth of respirations increase, eliminating additional CO2

41
Q

Compensation of metabolic alkalosis

A

rate and depth of respirations decrease, CO2 is retained

42
Q

Compensation of respiratory acidosis

A

kidneys conserve bicarbonate to restore carbonic acid:bicarbonate ratio of 1:20

43
Q

Compensations of respiratory alkalosis

A

kidneys excrete bicarbonate and conserve H+ to restore carbonic acid:bicarbonate ratio

44
Q

A client who is fasting is at risk for development of _____ _____. The body recognizes fasting as starvation and begins to metabolize its own proteins into _____, which are metabolic acids.

A

metabolic acidosis

ketones

45
Q

_____ is a disorder that can result in metabolic acidosis due to hyper-metabolic state

A

Hyperthyroidism

46
Q

Biggest disease with Bicarbonate loss (metabolic acidosis)

A

Chronic Renal Failure

47
Q

Metabolic alkalosis due to loss of _____ _____ which usually occurs because of vomiting or gastric suction.

A

hydrogen ions

48
Q

T/F: Encouraging fluids for an infant who is actively vomiting will not improve fluid balance status

A

T

*and neither juice nor glucose water is the best choice of fluid

49
Q

Frequent use of _____ _____ and daily use of _____ can cause metabolic alkalosis.

Overuse of _____ can be associated with metabolic acidosis.

A

calcium carbonate
furosemide

aspirin

50
Q

The client on Lasix (furosemide) may lose excess potassium, disposing the client toward metabolic alkalosis, the client should be taught to refrain from the use of _____ _____ when prone to metabolic alkalosis.

A

sodium antacids

51
Q

The client with Cushing’s syndrome is at risk for developing severe metabolic alkalosis that causes _____ and limits _____ _____

A

hypoxemia

energy reserves

52
Q

The client receiving _____ _____ is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse.

A

sodium bicarbonate

53
Q

Clients of _____ ages are at risk for respiratory acidosis when alveolar hypoventilation occurs

A

all

54
Q

Those with _____ are at highest risk for respiratory acidosis

A

COPD

55
Q

Respiratory alkalosis is usually always a result of _____

A

hyperventilation

56
Q

Major risk factor for respiratory acidosis

A

use of narcotics

*Morphine, oxycodone is a narcotic and generally acts to decrease or suppress respirations; therefore, client may hypo- ventilate causing CO2 retention, building up acid as the CO2 mixes with water to make carbonic acid

57
Q

_____ _____ from aspiration or other causes would put the client at risk for respiratory acidosis.

A

acute pneumonia

58
Q

_____ _____ diseases other than COPD, such as asthma, croup and cystic fibrosis put the child/ adult at risk for respiratory acidosis

A

Chronic lung

*Having only one functioning or partially functioning lungs could put a client at risk

59
Q

The manifestations of acute and chronic respiratory acidosis _____. The client with chronic respiratory acidosis will demonstrate daytime sleepiness. The client with acute respiratory acidosis may demonstrate warm, flushed skin, irritability, and blurred vision from the acute decline in oxygenation.

A

differ

60
Q

_____ _____ increase the risk for the acid-base imbalance respiratory alkalosis, due to hyperventilation that accompanies anxiety and panic attacks.

A

Anxiety disorders

61
Q

_____ can trigger increased respirations which can lead to respiratory alkalosis

A

Hypoxemia

62
Q

The client with a _____ overdose ( ASA or aspirin) is at risk for hyperventilation, which can lead to respiratory alkalosis due to over compensating for metabolic acidosis from the salicylate acid (asa)

Hyper-metabolic states can lead to increased respirations as well ( fever, thyrotoxicosis)

A

salicylate

63
Q

Symptoms of metabolic acidosis:

A
  • drowsiness
  • lethargy/weakness
  • confusion = NO HIGH FOWLER’S!
  • CNS depression leading to coma

Care:
prevent injury

64
Q

Infants and children are at high risk for _____ and _____ _____ because of immature kidneys

A

fluid and electrolyte imbalance

65
Q

infants have high respiratory rates, which can lead to _____ _____

A

insensible losses

66
Q

Older adults are at risk for F&E imbalances because of _____ kidney function, _____ sensations, and levels of _____ _____

A

decreased
thirst
intracellular fluid

67
Q

Define:

PaCO2 > 45

A

high = resp. acidosis

- less CO2 is being exhaled than normal

68
Q

Define:

PaCO2 < 35

A

low = resp. alkalosis

- more CO2 is being exhaled than normal

69
Q

Define:

HCO3 > 26

A

high = metabolic alkalosis

70
Q

Define:

HCO3 < 22

A

low = metabolic acidosis

71
Q

Define:

IS Compensation Present

A

PaCO2 & HCO3 are abnormal or nearly in opposite direction (1 acidic & 1 basic)

72
Q

Define:

IS compensation absent

A

1 component is abnormal and 1 is normal (acuter problem)

73
Q

Goal of treatment:

A

restore of maintain normal body balance

74
Q

Respiratory Acidosis:

The client with respiratory failure would benefit most from the _____-_____ or _____ _____ to increase ventilation

A

semi-Fowler’s or Fowler’s position

75
Q

Respiratory Acidosis:

_____ _____ _____ is the priority nursing diagnosis for the client with respiratory acidosis.

A

Impaired Gas Exchange

76
Q

Respiratory Alkalosis:
A method that is often used to control breathing for client’s experiencing hyperventilation is _____ _____ with the nurse during breathing exercises

A

eye contract

77
Q

Patients with metabolic alkalosis often have an accompanying _____ _____ _____. With the fluid volume deficit, the client would experience _____.

A

fluid volume deficit

hyperthermia

78
Q

Metabolic Alkalosis: The client is at risk for injury because of the associated _____ _____ _____ _____

A

muscle spasms and dizziness

79
Q

Metabolic Alkalosis:
The depressed respiratory drive that often accompanies metabolic alkalosis can lead to _____ and _____ _____ of the tissues, so monitoring oxygen saturation is an important intervention.

A

hypoxemia

impaired oxygenation

80
Q

Metabolic Alkalosis:
Oxygen saturation levels of less than _____ indicate significant oxygenation problems. Changes in mental status or behavior may be early signs of _____.

A

90%

hypoxia

81
Q

Treatment of metabolic alkalosis includes restoring normal _____ _____ and administering _____ _____

A

fluid volume

potassium chloride

82
Q

Taking too many _____ is associated with metabolic alkalosis, so the client needs teaching related to this concept

A

antacids

83
Q

_____ _____ _____ : A drop in oxygen will change the client’s level of responsiveness, so always monitor for cognition

A

Low oxygen levels

84
Q

Metabolic acidosis affects cardiac output by _____ contractility, _____ the heart rate, and _____ the risk for dysrhythmias.

A

decreasing
slowing
increasing

85
Q

The client with metabolic acidosis will be at risk for developing an _____ _____ _____, due to administration of sodium Bicarbonate to help correct the acidosis which can lead to _____ and then Fluid Vol excess.

A

Excessive Fluid Volume

hypernatremia

86
Q

Metabolic alkalosis:

The ECG pattern may shows changes similar to those seen with _____.

A

hypokalemia

87
Q

Goal in acidosis:

A

reverse the effects of excess acids & return pH to norma levels quickly

88
Q

Metabolic Acidosis:
Education concerning the connection that: Taking a potassium supplement may cause _____, which _____ cardiac output and _____ metabolic acidosis

A

hyperkalemia
decreases
worsens

89
Q

Sodium bicarbonate is administered only if the bicarbonate level is _____: because: Administering bicarbonate to correct acidosis increases the risk for hypernatremia, hyperosmolality, and fluid volume excess. This is an order that the nurse should question before providing

A

low

90
Q

DO NOT USE ANY ANTACID FOR MORE THAN…

A

2 weeks

91
Q

The client receiving _____ _____ is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse.

A

sodium bicarbonate

92
Q

When to use intubation

A

if PaCO2 is > 77 mmHg, pH < 7.20

93
Q

Quick correction of chronic hypercarbia (increased levels of CO2) may cause…

A

metabolic alkalosis (body overcompensates with HCO3 kidney retention)

94
Q

If a client is exhibiting respiratory acidosis bases on low ph. and high PaCO2 levels, then the client needs to “blow off” more CO2; therefore, the respiratory rate would be _____ on the machine

A

increased

95
Q

For a client being mechanically ventilated, the only way to reduce rapid respirations might be to provide a _____

A

sedative

Nursing 2300 (VIcky Hansen) (64 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions