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Week 2 Flashcards

1
Q

pH range

A

7.35-7.45

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2
Q

PaCO2

A

35-45 mm Hg

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3
Q

HCO3

A

22-26 mEq/L

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4
Q

PaO2

A

80-100 mm Hg

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5
Q

kidneys regulate ____ in the ECF

A

bicarbonate

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6
Q

lungs regulate ___ and thus the carbonic acid in ECF

A

CO2

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7
Q

the more hydrogen ions there are, the ___ the pH =more acidic

A

lower

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8
Q

____ production of bicarbonate is the most common in the body

A

pancreatic

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9
Q

Acid-Base buffer system: 1st action

A

protein and chemical buffers- within seconds

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10
Q

Acid-Base Buffer system: 2nd action

A

respiratory system- within minutes to hours

*carbonic acid system and respiratory

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11
Q

Acid-Base Buffer system: 3rd action

A

Kidneys and Bicarbonate- within hours to days

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12
Q

Increased CO2 = _____ventilation

A

hyper

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13
Q

decrease free H and decreased CO2= ____ventilation

A

hypo

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14
Q

carbonic anhydrase equation

A

20:1 keeps pH normal
20 parts Bicarb to 1 carbonic acid

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15
Q

Kidneys excrete extra hydrogen and/or reabsorb ___ to ___ pH

A

bicarb; balance

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16
Q

If pH ____ the kidneys retain HCO3

A

decreases

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17
Q

If pH increases, the kidneys ______ HCO3

A

excrete

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18
Q

pH= kidney function= Bicarb levels- ___

A

slow

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19
Q

Lung function= Carbon Dioxide level- ___

A

rapid

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20
Q

ROME

A

Respiratory
Opposite
Metabolic
Equal

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21
Q

think respiratory with ____

A

carbon dioxide CO2

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22
Q

think metabolic with ___

A

bicarb HCO3

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23
Q

Respiratory: high CO2 = ____ pH

A

low

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24
Q

Metabolic: High Bicarb = ___ pH

A

high

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25
Q

calcium binds better be ___ pH

A

high

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26
Q

metabolic acidosis= ___kalemia

27
Q

4 main causes of metabolic acidosis

A

overproduction of hydrogen ions-aspirin, alcohol
under elimination of hydrogen ions- kidney failure, severe lung disease
under production of bicarb ions- kidney/pancreas related
overelimination of bicarb ions- diarrhea

28
Q

anion gap normal range

A

8-12 mEq/L

29
Q

what is the definition of anion gap

A

difference between the sum of cations (+) and anions (-) in the blood

30
Q

<8 anion gap indicates

A

base accumulation

31
Q

> 12 anion gap indicated

A

acid accumulation

32
Q

> 16 anion gap indictaes

A

excessive unmeasured anions in the blood

33
Q

“open/positive/elevated” anion gap is great than ___ (numerical)

34
Q

what causes a large gap? (anion)

A

accumulation of hydrogen

35
Q

metabolic acidosis clinical manifestations

A

-Headache, confusion, drowsiness, increased RR and depth, nausea, vomiting
-Cold clammy skin, dysrhythmias and shock
-Vasodilation, decreased BP and decreased CO
s/s increased potassium and increased free calcium

36
Q

assessment and diagnostics for metabolic acidosis

A

pH <7.35
bicarbonate <22
hyperkalemia

37
Q

Acute Metabolic Acidosis: DKA
No insulin present to turn ____ into fuel

38
Q

Acute Metabolic Acidosis: DKA
No glucose mean the body breaks down ___ for fuel which creates ____ as a waste product

A

fat; ketones

39
Q

Acute Metabolic Acidosis: DKA
Person is in a persistent ____ state from the _____

A

acidotic; ketones

40
Q

Acute Metabolic Acidosis: DKA
Need the ___ ___ to close before stopping ____

A

anion gap; insulin

41
Q

Acute Metabolic Acidosis: DKA
s/s

A

High Blood Sugar and Urine Ketones
Excessive Thirst, Frequent Urination, N/V, Fatigue, Confusion, Fruity Breath
Severe Electrolyte Imbalance
Kussmaul breathing- deep rapid breathing

42
Q

Respiratory Acidosis: Retention of CO2 based on 4 causes

A

respiratory depression
inadequate chest expansion
airway obstruction
reduced alveolar capillary diffusion

43
Q

Respiratory Acidosis: Assessment and Dx

A

low pH <7.35
PaCO2 >45mm Hg
Chest xray

44
Q

Respiratory Acidosis:: Clinical manifestations

A

changes in breathing pattern and LOC

45
Q

Respiratory Acidosis: Medical management

A

Treatment aimed at improving ventilation:
-Bronchodilators, antibiotics, thrombolytic
-Pulmonary Toileting/Hygiene
-Semi Fowlers positions
-Mechanical ventilation

46
Q

Acute Respiratory Acidosis causes

A

narcotics
myasthenia gravis, MS
ingestion of foreign object

Pulmonary hygiene/pneumonia
-atelectasis= when smaller lung fields collapse

47
Q

Alkalosis: Hypo-?

A

Hypo-
calcemia, chloremia, kalemia

48
Q

Acute/Chronic Metabolic Alkalosis:
Most common cause

A

vomiting or gastric suction

49
Q

Acute/Chronic Metabolic Alkalosis:
other causes

A

long term diuretic use
hypokalemia

50
Q

Acute/Chronic Metabolic Alkalosis:
Assessment & Dx

A

high pH > 7.45
high bicarb >26 mEq/L

urine chloride

51
Q

Acute/Chronic Metabolic Alkalosis: Clinical Manifestations

A

Symptoms related to decreased calcium:
Tingling of the fingers and toes, dizziness and hypertonic muscles

Respiratory depression (due to compensation), atrial tachycardia, decreased gastric motility and paralytic ileus

Symptoms of hypokalemia
Muscle weakness, flattened t-wave, u-wave, decreased bowel sounds, fatigue

52
Q

Acute and Chronic Respiratory Alkalosis: Patho

A

Always due to hyperventilation- extreme anxiety, inappropriate ventilator settings, hypoxemia, chronic hypocapnia

53
Q

Acute and Chronic Respiratory Alkalosis: Dx Findings

A

High pH >7.45
PaCO2 <35 mm Hg

54
Q

Acute and Chronic Respiratory Alkalosis: Clinical Manifestations

A

lightheadedness, inability to concentrate, numbness and tingling,
Decreased cerebral blood flow with sometimes loss of consciousness
Tachycardia, atrial and ventricular arrhythmias

55
Q

Acute and Chronic Respiratory Alkalosis: Medical Management

A

paper bag breathing
anti-anxiety
ventilator setting changes

56
Q

Metabolic and respiratory acidosis during ___ ___

A

cardiac arrest

57
Q

PaCO2 alkalosis value

A

<35 mmHg
hyperventilation- not enough retained

58
Q

PaCO2 acidosis value

A

> 45 mmHg
hypoventilation

59
Q

Bicarb HCO3 alkalosis value

60
Q

Bicarb HCO3 acidosis value

61
Q

Normal range HCO3

A

22-26 mEq/L

62
Q

PaO2 normal range

A

80-100 mmHg

331 (7 decks)

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