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SAV NUR 406 exam 1 > week 2 content > Flashcards

week 2 content Flashcards

1
Q

______ – reflects the concentration of hydrogen ions that are present in that solution (it’s an inverse relationship)

A

pH

low pH (acidosis) = high hydrogen
high pH (alkolosis) = low hydrogen

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2
Q

_____ pH = ___ hydrogen = alkaline (basic)

neutral = equal parts hydrogen ions (H+) and hydroxide ions (OH-)

____ pH = _____ hydrogen = acidic (acidic)

A

high pH = low hydrogen = alkaline (basic)

neutral = equal parts hydrogen ions (H+) and hydroxide ions (OH-)

low pH = high hydrogen = acidic (acidic)

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3
Q

high pH = 7.46 or more is called _____

low pH = 7.34 or less is called ______

A

alkaline/basic

acidic

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4
Q

acidic = high or low pH?

alkaline/basic = high or low pH?

A

low

high

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5
Q

neutral normal range for pH in blood

A

7.35-7.45

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6
Q

T/F
acid-base balance can affect:
1. electrolytes = Na, K, Cl
2. hormones
3. oxygen transport and delivery (hgb)

A
  1. T
  2. T
  3. T
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7
Q

pH < 6.8 and > 7.8 = (incompatible with life)

pH < 6.8 or > 7.8 effects?
- cellular metabolism
- enzyme activity
- O2 delivery to tissues

pH < 6.8 or > 7.8 effects?
- Essential bodily function in CV and nervous systems

A

pH < 6.8 (incompatible with life) effects =
- cellular metabolism
- enzyme activity
- O2 delivery to tissues

pH > 7.8 (incompatible with life) effects =
- Essential bodily function in CV and nervous systems

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8
Q

Acid-base balance and oxygen transport and delivery (hgb)
high or low pH = hgb will give up O2 more readily at the tissue
high or low pH = hgb will hold onto O2 and will not give it the tissue so tissue struggles with oxygenation

A
  • high acidic/low pH/high hydrogen = hgb will give up O2 more readily at the tissue (bc it is high hydrogen)
  • high alkolotic/high pH/low hydrogen = hgb will hold onto O2 and will not give it the tissue so tissue struggles with oxygenation (bc it is low hydrogen)
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9
Q

acids or bases have more hydrogen ions = they can donate hydrogen

acids or bases have less hydrogen ions = they can accept hydrogen ions AND give up hydroxide ion

A

acidic substances/acids have more hydrogen ions = they can donate hydrogen

bases/alkaline substance have less hydrogen ions = they can accept hydrogen ions AND give up hydroxide ion

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10
Q

Stomach acid (hydrochloric acid) and lemon juice = VERY _______ = low pH and high hydrogen

Blood, milk, saliva = neutral

Lye, bleach, ammonia, milk of magnesia = VERY _________ = high pH and low hydrogen

A

Stomach acid (hydrochloric acid) and lemon juice = VERY acidic = low pH and high hydrogen

Blood, milk, saliva = neutral

Lye, bleach, ammonia, milk of magnesia = VERY alkaline = high pH and low hydrogen

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11
Q

Functions of _________:
- helps maintain cell membrane
- Helps with enzyme activity
- Part of H2O
- Keeps body hydrated
- Helps with energy production

A

Hydrogen

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12
Q

2 types of acids in the body

A

volatile and non volatile

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13
Q

Volatile acids vs nonvolatile acids?
- can be converted to gas
- Execrated/eliminated by lungs
- ex: carbonic acid (H2CO3)
- This gets broken down to H2O and CO2 in the lungs allowing the lungs to expel CO2

A

Volatile acids

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14
Q

Volatile acids vs nonvolatile acids?
- excreted by kidneys
- Ex:
- Phosphoric acid
- Sulfuric acid
- Acetoacetic acid
- Beta-hydroxybutyric
- Lactic acid***

***(not excreted by kidneys, by-product of anerobic metabolism, it can be reconverted if O2 is reestablished to tissues and can be used for energy production)

A

Nonvolatile acids

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15
Q

is alkalosis or acidosis more difficult to correct

A
  • avoid alkalosis (high pH/low hydrogen) – especially if person is ill , bc hgb hold onto O2 more, wont oxygenate tissue
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16
Q

General cause of imbalance is either metabolic or respiratory
- if HCO3/bicarb levels change = 2ndary to _________
- if H2CO3/carbonic acid level changes = 2ndary to _____________

A

metabolic/kidneys

respiratory/lungs

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17
Q

Primary disorder vs Primary event

____________ – the problem that initiates the acid-base imbalance

______________ – what results from the primary event

A

Primary event

Primary disorder

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18
Q

Primary disorder vs Primary event

hypoventilation = respiratory acidosis

vomiting = metabolic alkalosis

A

Primary event (hypoventilation) = primary disorder (respiratory acidosis)

Primary event (vomiting) = primary disorder (metabolic alkalosis)

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19
Q

__________ acidosis or alkalosis
- increase or decrease in CO2
- changes in ventilation

_________ acidosis or alkalosis
- changes in H ion or bicarb ions

A

Respiratory

Metabolic

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20
Q

ROME

When pH increases = CO2 __creases = alkalosis or acidosis?
When pH decreases = CO2 __creases = alkalosis or acidosis?

When pH increases = HCO3 __creases = alkalosis or acidosis?
When pH decreases = HCO3 __creases = alkalosis or acidosis?

A

ROME

R – respiratory
O – opposite

So, we think respiratory = CO2
When pH increases = CO2 decreases = alkalosis
When pH decreases = CO2 increases = acidosis

M – metabolic
E – equal

So we think metabolic = HCO3
When pH increases = HCO3 increases = alkalosis
When pH decreases = HCO3 decreases = acidosis

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21
Q

When pH decreases and HCO3 decreases =

HCO3/bicarb deficit in ECF
Due to
- excess acid (kidney dysfunction cant excrete)
- loss of bicarbs (kidney dysfunction cant conserve or produce)

A

Metabolic acidosis

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22
Q

to compensate kidneys can:
- Can eliminate large amounts of ______ (except carbonic acid)
- Can eliminate ______ (body excretes bicarb)
- can conserve and produce ________

A
  • Can eliminate large amounts of acid (except carbonic acid)
  • Can eliminate base when pH is too basic = body excretes bicarb
  • can conserve and produce bicarb ions – ex: if COPD pts have high CO2 and high bicarb the kidneys can conserve it to try to lower it and maintain pH
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23
Q

Metabolic acidosis

expected ABGs before compensation
high, low, WNL
pH =
paCO2 =
HCO3 =

A

pH = <7.35 LOW acidic
paCO2 = 35-45 WNL
HCO3 = <24 LOW

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24
Q

s/s
- CNS changes
- Lethargy, drowsy
- Confusion
- Tremors, cramps
- Paresthesia – finger/toes tingle
- hypotension
- Hyperkalemia
- deep breathing – kussmaul respirations (w/ DKA)
- fruit breath odor (w/ DKA)

s/s
- CNS over excitability
- confusion
- tremors
- muscle cramps
- paresthesia – fingers and toes tingle
- coma
- n/v/d
- respiratory depression – lungs are holding onto CO2

s/s
- CNS depression
- hypoventilation
- dyspnea
- respiratory depression
- shallow respirations
- h/a
- restlessness
- confusion
- tachycardia, arrythmias
- decreased LOC, stupor, coma
- “can’t catch my breath”

s/s
- CNS overexcitability
- tachypnea
- light headedness
- confusion
- blurred vision
- paresthesia – fingers and toes tingle
- hyperactive reflexes
- seizures
- coma

A

metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkalosis

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25
Q

Causes of ____________
- hyperventilation (blowing off too much CO2)
- anxiety/panic attack – anything causing hyperventilation
- increased metabolic demands – fever, sepsis
- medications
- hypoxia
- PE or lung disease
- CNS lesions
- ventilator setting

Causes of _____________
- hypoventilation (retains too much CO2)
- acute = respiratory arrest (kidneys don’t have time to compensate)
- chronic = COPD (kidneys have time to compensate)
- cardiopulmonary arrest
- head injury
- narcotics/sedatives
- anesthesia
- pulmonary disorders – acute asthma, COPD exacerbation, PNA, respiratory failure
- pain
- abdominal distension
- airway obstruction
- chest wall deformities
- neuromuscular problems

Causes of ____________
- consuming excess base/basic (ex: baking soda, alka-seltzer) = causes hypokalemia which causes H ions to shift out of cell and potassium to go into cell
- prolonged vomiting
- NG tube
- diuretics

Common causes of ___________
- kidney failure
- fistulas
- DMT1 DKA
- lactic acidosis
- prolonged diarrhea = loss of HCO3 increases acid
- starvation = body using fat for energy = ketosis
- med OD – ASA
- shock
- cardiac arrest

A

respiratory alkalosis
respiratory acidosis
metabolic alkalosis
metabolic acidosis

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26
Q

high pH and HCO3 increases

due to
- too much bicarb (base)
- not enough carbonic acid

A

Metabolic alkalosis

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27
Q

Metabolic alkalosis

expected ABGs before compensation high, low, WNL
pH =
paCO2 =
HCO3 =

A

pH = >7.48 HIGH basic
paCO2 = 35-45
HCO3 = >29 HIGH

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28
Q

Low pH and high CO2

due to
- too much retention of CO2 in lungs
- H2CO3 (carbonic acid) excess in ECF

A

Respiratory acidosis
can be acute or chronic

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29
Q

Respiratory acidosis

expected ABGs before compensation high, low, WNL
pH =
paCO2 =
H2CO3 = (with acute)

A

pH = < 7.35 LOW acidic
paCO2 = >45 HIGH acidic
H2CO3 = 24-29 WNL (with acute)

30
Q

Respiratory alkalosis

expected ABGs before compensation high, low, WNL
pH =
paCO2 =
H2CO3 =

A

ABGs
pH = >7.45 HIGH basic
paCO2 = <35 LOW basic
H2CO3 = 24-29 WNL

31
Q

high pH and low CO2

due to:
- too much loss of CO2 from lungs
- H2CO3 (carbonic acid) deficit in ECF

A

Respiratory alkalosis

32
Q

high pH and low CO2
Low pH and high CO2
high pH and high HCO3
low pH and low HCO3

A

Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
Metabolic acidosis

33
Q

(3) Acid-base balance/homeostasis systems

A
  1. buffers
  2. respiratory system
  3. renal system
34
Q

which Acid-base balance/homeostasis system?

Chemicals in the body that combine with acid or base to change pH
- they accept or release hydrogen ions
- occurs almost instantaneously (within secs)
- short lived effect

contains 3 main systems
1. bicarbonate-carbonic acid
2. phosphate
3. protein and hemoglobin

A
  1. Buffers
35
Q

bicarbonate-carbonic acid buffer system
location =

A

ECF

36
Q

Acid-base balance/homeostasis systems: bicarbonate-carbonic acid buffer

The chemical equilibrium:

___ + ____ ⇌ _______ ⇌ ____ + ____

A

The chemical equilibrium:
CO2 + H2O ⇌ H2CO3 ⇌ H+ + HCO3-
carbon dioxide
water

Carbonic Acid

hydrogen ion (pH)
Bicarb

37
Q

Acid-base balance/homeostasis systems: bicarbonate-carbonic acid buffer

CO2 = byproduct of __________
- CO2 can be blown out = this _____ pH
OR
- CO2 can be held on to = this _____ pH

A

cellular metabolism
raises
lowers

Ex: COPD pt or pt with respiratory depression from OD = lungs can’t expel CO2 b/c RR is so low = high CO2

38
Q

Acid-base balance/homeostasis systems: bicarbonate-carbonic acid buffer

______ _______ = breaks down carbonic acid

A

Carbonic anhydrase

39
Q

Acid-base balance/homeostasis systems: bicarbonate-carbonic acid buffer

Carbonic anhydrase = breaks down carbonic acid

found in:
1. Carbonic anhydrase in the lungs = H2O + CO2 = lungs exhale CO2 = _______ pH
2. Carbonic anhydrase in the kidneys = H+ + HCO3 = excrete H+ in urine = ______ pH

  • this is how the body compensates for very acidic levels/ low pH or very alkalotic levels/high pH?
  • if body isn’t compensating = give ______ to ______ pH
A

raises
raises

very acidic levels/ low pH

sodium bicarb - raises pH

40
Q

sodium bicarb - raises or lowers pH?

treats acidosis or alkalosis?

A

raises pH

acidosis

41
Q

Acid-base balance/homeostasis systems: bicarbonate-carbonic acid buffer

how the lungs compensate for acidosis:

  1. When pH is _____ (more acidic and high hydrogen): body needs to get rid of _____
  2. Excess H+ ions combine with bicarbonate ions to form _________.
  3. Carbonic acid then dissociates into _____ and ______.
  4. The lungs expel the excess CO2, thereby reducing the acidity (___crease pH and __crease hydrogen)
A
  1. When pH decreases (more acidic and high hydrogen): body needs to get rid of hydrogen
  2. Excess H+ ions combine with bicarbonate ions to form carbonic acid.
  3. Carbonic acid then dissociates into CO2 and H2O.
  4. The lungs expel the excess CO2, thereby reducing the acidity (increase pH and lowering hydrogen)
42
Q

Acid-base balance/homeostasis systems:

____________ buffer
- main intracellular buffer
- can’t measure b/c its intracellular
- works by picking up a hydrogen ion to balance pH inside the cell

A

Phosphate

43
Q

Acid-base balance/homeostasis systems:

__________ and _________ buffer
almost all proteins can function as buffers

carboxyl group (COOH) = amino acid and acetic acid
- Weak acid that ________ H+ ion

amino group (NH2-) = amino acid and ammonia
- ______ H+ ion

hemoglobin
- _________ CO2 at the cellular level

A

protein and hemoglobin

gives up

Accepts

Picks up/accepts

44
Q

Cellular compensation: Part of the buffer system
- Cells like to have a neutral charge
- H+ ions = positive
- K+ ions = positive (mostly found inside cell)

  1. When the body is acidic, theres a ___crease in H ions
  2. H ions move ____ cell
    3.there is now too many positively charged ions in the cell
  3. K moves ____ cell
  4. there is now too much K+ in the _____
  5. the ____ is neutral, but the ______ is hyperkalemic (dysrhythmias)
  6. the kidneys (if working) will excrete the excess ____
  7. K+ will ______ cell as pH returns to normal
  8. UNLESS the kidneys excreted all the body’s K+, then when pH levels return to normal there is no K+ left to go back into cell, and there is a __________
A
  1. When there is an increase in H ions (pH decreases/acidic increases)
  2. H ions move into cell
    3.there is now too many positively charged ions in the cell
  3. K moves out of the cell
  4. there is now too much K+ in the blood
  5. the cell is neutral, but the blood is hyperkalemic (dysrhythmias)
  6. the kidneys (if working) will excrete the excess K+
  7. K will go back into cell as pH returns to normal
  8. UNLESS the kidneys excreted all the body’s K+, then when pH levels return to normal there is no K+ left to go back into cell, and there is a depletion of K+
45
Q

Acid-base balance/homeostasis systems: Respiratory mechanisms

Body makes CO2

CO2 + H2O ⇌ H2CO3
carbon water Carbonic
dioxide Acid

exhalation excretes_________

  1. does this affect fixed/non-volatile acids such as lactic acid?
  2. the body can adjust pH by changing _____ and ________
  3. if acidic (low pH/high hydrogen) = ___creased RR and depth = exhale more CO2
  4. if alkaline/basic (high pH/low hydrogen) = __crease RR and depth = hold onto more CO2
A

carbonic acid

  1. no
  2. rate and depth of breathing
  3. increase
  4. decrease
46
Q

Acid-base balance/homeostasis systems:

  • Last system to kick in to balance pH
  • Does long term pH balance
  • Most effective regulator of pH
  • If _______ fail = pH balance fails (would have to take daily bicarb)
A
  1. kidney excretion
47
Q

Acid-base balance/homeostasis systems: kidney excretion

  • Can eliminate large amounts of _______ (except carbonic acid)
  • Can eliminate base when pH is too basic = body excretes _______
  • can conserve and produce ________
A

acid

bicarb

bicarb
ex: if COPD pts have high CO2 and high bicarb the kidneys can conserve it to try to lower it and maintain pH

48
Q

Acid-base balance/homeostasis systems: kidney excretion

__________ (low pH/high hydrogen)
Goal = raise pH
kidneys respond by:
- ___creasing reabsorption of bicarbonate
- ___creasing secretions of hydrogen ions (acid component) into the urine

__________ (high pH/low hydrogen)
goal = lower pH
kidneys respond by:
- __creasing bicarb reabsorption
- __crease hydrogen ion into urine

A

Acidosis (low pH/high hydrogen)
Goal = raise pH
kidneys respond by:
- increasing reabsorption of bicarbonate (and make new)
- increasing secretions of hydrogen ions (acid component) into the urine

alkalosis/basic (high pH/low hydrogen)
goal = lower pH
kidneys respond by:
- decreasing bicarb reabsorption
- decrease hydrogen ion into urine

49
Q

Rates of correction
1st – ________ function almost instantaneously
2nd – _________ function in several minutes to hours
3rd – _________ functions in several hours to days

respiratory mechanisms
kidney excretion/mechanism
buffers

A

Rates of correction
1st – buffers function almost instantaneously
2nd – respiratory mechanisms function in several minutes to hours
3rd – kidney excretion/mechanism functions in several hours to days

50
Q

Compensation - The body’s response to acid base imbalance (for a short time?)

________ compensation =
pH is abnormal
acid or base component is abnormal (CO2 or HCO3)

________ compensation –
pH is abnormal
acid and base component is abnormal (CO2 and HCO3)

________ compensation –
pH is normal
acid and base component is abnormal and pointing in same direction (CO2 and HCO3)

_________ compensation -
pH is normal
acid and base component are normal (CO2 and HCO3)

A

uncompensated = body has not responded

partial = one of the system(s) are trying to compensate, but pH is still abnormal

compensated/complete compensation = the body is compensating

corrected = everything is back to normal

51
Q

If underlying problem is metabolic (kidneys) = __________ compensation can help (within ________)
- ______________
- ______________

A

respiratory (lung)

mins-hours

  • hyperventilation
  • hypoventilation
52
Q

If underlying problem is metabolic (kidneys) = respiratory (lung) compensation can help (within mins-hours)
- hyperventilation
- hypoventilation

Acidosis (____ pH/high hydrogen)
Goal = __crease pH
1. stimulates brain and arterial receptors
2. __creased RR and depth (hyper or hypo ventilation to blow off CO2)?
3. CO2 __creases
4. carbonic acid __creases
5. pH __creases

alkalosis/basic (___ pH/low hydrogen)
goal = __crease pH
1. stimulates brain and arterial receptors
2. __creased RR and depth (hyper or hypo ventilation hold onto CO2)?
3. CO2 __creases
4. carbonic acid __creases
5. pH __creases

A

Acidosis (low pH/high hydrogen)
Goal = increase pH
1. stimulates brain and arterial receptors
2. increased RR and depth (hyperventilation to blow off CO2)
3. CO2 decreases
4. carbonic acid decreases
5. pH increases

alkalosis/basic (high pH/low hydrogen)
goal = decrease pH
1. stimulates brain and arterial receptors
2. decreased RR and depth (hypoventilation hold onto CO2)
3. CO2 increases
4. carbonic acid increases
5. pH decreases

53
Q

Metabolic alterations = metabolic acidosis/alkalosis = ______ compensation (within _____)
- conserving CO2 = alkalosis or acidosis correction?
- excreting CO2 = alkalosis or acidosis correction?

(kidneys can also attempt to correct by retaining/excreting ________)

A

lung
min - hours
alkalosis
acidosis
HCO3/bicarb

54
Q

If underlying problem is respiratory (lungs) = ____________ compensation can help (within _________)

A

If underlying problem is respiratory (lungs) = metabolic (kidneys) compensation can help (within hours to days)
- renal mechanism

55
Q

If underlying problem is respiratory (lungs) = metabolic (kidneys) compensation can help (within hours to days)
- renal mechanism

Acidosis (___ pH)
Goal = __crease pH
1. kidneys will _______ bicarb back into bloodstream
2. kidneys will _______ hydrogen ions via urine

alkalosis/basic (___ pH)
goal = __crease pH
1. kidneys will _____ bicarb

A

Acidosis (low pH/high hydrogen)
Goal = increase pH
1. kidneys will reabsorb bicarb back into bloodstream
2. kidneys will excrete hydrogen ions via urine

alkalosis/basic (high pH/low hydrogen)
goal = decrease pH
1. kidneys will excrete bicarb

56
Q

Respiratory alterations = Respiratory acidosis/alkalosis = ______ compensation (within ______):
- __________ H2CO3/bicarb = acidosis correction
- __________ H2CO3/bicarb = alkalosis correction

A

Respiratory alterations = Respiratory acidosis/alkalosis = kidney compensation (in hours-days):
- conserving/reabsorbing H2CO3/bicarb = acidosis correction
- excreting H2CO3/bicarb = alkalosis correction

57
Q

Normal values
pH =
CO2 =
pO2 =
HCO3 =
O2 sat =

24-29
7.35-7.45
35-45
95-100%
80-100

A

Normal values
pH = 7.35-7.45
CO2 = 35-45
pO2 = 80-100
HCO3 = 24-29
O2 sat = 95-100%

58
Q

Normal values
pH =
CO2 =
pO2 =
HCO3 =
O2 sat =

A

Normal values
pH = 7.35-7.45
CO2 = 35-45
pO2 = 80-100
HCO3 = 24-29
O2 sat = 95-100%

59
Q

_____________
Purpose
- assess acid base status
- determine adequacy of oxygenation and ventilation

which is more accurate ABG or VBG?

A

Arterial Blood Gas

ABG

60
Q

_____ tells you:
- pH = 7.35-7.45
- PaCO2 = 35-45
- respiratory parameter
- tells you the partial pressure of CO2
in artery
- HCO3 bicarb = 24-29
- metabolic parameter
- Calculated on the ABG
- Reported as CO2 on chemistry panel
- Serum CO2

_________ tells you:
- pH = 7.31-7.41
- PvCO2 = 41-51
- Tells you partial pressure of CO2 in
the vein
- HCO3 bicarb = 24-29
- Calculated value

______
- contains serum CO2 = HCO3 (bicarb) (24-29)

A

ABG
VBG
BMP

61
Q

ABG vs VBG

  • pH = 7.35-7.45
  • pH = 7.31-7.41
  • PaCO2 = 35-45
  • PvCO2 = 41-51
  • HCO3 bicarb = 24-29
  • HCO3 bicarb = 24-29
A

ABG
VBG

ABG
VBG

ABG
VBG

62
Q

Tells you partial pressure of CO2 in
the vein

tells you the partial pressure of CO2
in artery

A

PvCO2 = 41-51 (VBG)

PaCO2 = 35-45 (ABG)

63
Q

interpreting ABGs
1. see if pH is normal or abnormal
________ = compensated or corrected
________ = uncompensated or partial
(if pH normal still see which way it is leaning to determine acidosis or alkalosis)

  1. see if PCO2 is normal or abnormal
    ________ = not a respiratory problem
    ________ = respiratory problem (ROME = pH and PCO2 arrows will be _____ direction)
  2. see if HCO3 is normal or abnormal
    _________ = not a metabolic problem
    _________ = metabolic problem (ROME = pH and HCO3 arrows will be _____ direction)
  3. see what the level of compensation is by looking at pH, PCO2, HCO3:
    pH ________ + PCO2 ___ HCO3 abnormal = uncompensated
    pH ________ + PCO2 ___ HCO3 abnormal = partial
    pH ________ + PCO2 ___ HCO3 abnormal = compensated
    pH ________ + PCO2 ___ HCO3 normal = corrected
A

interpreting ABGs
1. see if pH is normal or abnormal
normal = compensated or corrected
abnormal = uncompensated or partial
(if pH normal still see which way it is leaning to determine acidosis or alkalosis)

  1. see if PCO2 is normal or abnormal
    normal = not a respiratory problem
    abnormal = respiratory problem (ROME = pH and PCO2 arrows will be opposite direction)
  2. see if HCO3 is normal or abnormal
    normal = not a metabolic problem
    abnormal = metabolic problem (ROME = pH and HCO3 arrows will be same direction)
  3. see what the level of compensation is by looking at pH, PCO2, HCO3:
    pH abnormal + PCO2 or HCO3 abnormal = uncompensated
    pH abnormal + PCO2 and HCO3 abnormal = partial
    pH normal + PCO2 or HCO3 abnormal = compensated
    pH normal + PCO2 and HCO3 normal = corrected
64
Q

interpreting ABGs
1.
pH = 7.26
CO2 = 63
HCO3 = 24

A

Normal values
pH = 7.35-7.45
CO2 = 35-45
pO2 = 80-100
HCO3 = 24-29
O2 sat = 95-100%

pH = low = acidosis
CO2 = high = opposite direction arrows = respiratory issue
HCO3 = normal

respiratory acidosis, uncompensated (OR)

65
Q

interpreting ABGs
2.
pH = 6.95
CO2 = 30
HCO3 = 5

A

Normal values
pH = 7.35-7.45
CO2 = 35-45
pO2 = 80-100
HCO3 = 24-29
O2 sat = 95-100%

pH = low = acidosis
CO2 = low = not a respiratory issue bc same direction
HCO3 = low = metabolic issue bc same direction

metabolic acidosis, partial (AND)

66
Q

interpreting ABGs
3.
pH = 7.43
CO2 = 78
HCO3 = 42

A

Normal values
pH = 7.35-7.45
CO2 = 35-45
pO2 = 80-100
HCO3 = 24-29
O2 sat = 95-100%

pH = normal = leaning high = alkalosis
CO2 = high = not a respiratory issue bc same direction (ROME)
HCO3 = high = metabolic issue bc same direction (ROME)

metabolic alkalosis, compensated (pH normal, CO2 or HCO3 abnormal)

67
Q
  • hyperventilation causes respiratory acidosis or alkalosis
  • hypoventilation causes respiratory acidosis or alkalosis
A

Causes of respiratory alkalosis
- hyperventilation (blowing off too much CO2)

Causes of respiratory acidosis
- hypoventilation (retains too much CO2)

68
Q

Common causes of ___________
- kidney failure
- fistulas
- DMT1 DKA
- lactic acidosis
- prolonged diarrhea = loss of HCO3 increases acid
- starvation = body using fat for energy = ketosis
- med OD – ASA
- shock
- cardiac arrest

A

metabolic acidosis

69
Q

Causes of __________
- consuming excess base/basic (ex: baking soda, alka-seltzer) = causes hypokalemia which causes H ions to shift out of cell and potassium to go into cell
- prolonged vomiting
- NG tube
- diuretics

A

metabolic alkalosis

70
Q
  • CNS over excitability
    s/s of acidosis or alkalosis
  • CNS depression
    s/s of acidosis or alkalosis
A

alkalosis

acidosis

71
Q

would these:

  • cardiopulmonary arrest
  • head injury
  • narcotics/sedatives
  • anesthesia
  • pulmonary disorders – acute asthma, COPD exacerbation, PNA, respiratory failure
  • pain
  • abdominal distension
  • airway obstruction
  • chest wall deformities
  • neuromuscular problems

cause hyper or hypo ventilation?

resulting in acidosis or alkalosis?

A

Causes of respiratory acidosis
- hypoventilation (retains too much CO2)

72
Q

would these:

  • anxiety/panic attack
  • increased metabolic demands – fever, sepsis
  • medications
  • hypoxia
  • PE or lung disease
  • CNS lesions
  • ventilator setting

cause hyper or hypo ventilation?

resulting in acidosis or alkalosis?

A

Causes of respiratory alkalosis
- hyperventilation (blowing off too much CO2)

SAV NUR 406 exam 1 (3 decks)

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