week 2 content Flashcards
______ – reflects the concentration of hydrogen ions that are present in that solution (it’s an inverse relationship)
pH
low pH (acidosis) = high hydrogen
high pH (alkolosis) = low hydrogen
_____ pH = ___ hydrogen = alkaline (basic)
neutral = equal parts hydrogen ions (H+) and hydroxide ions (OH-)
____ pH = _____ hydrogen = acidic (acidic)
high pH = low hydrogen = alkaline (basic)
neutral = equal parts hydrogen ions (H+) and hydroxide ions (OH-)
low pH = high hydrogen = acidic (acidic)
high pH = 7.46 or more is called _____
low pH = 7.34 or less is called ______
alkaline/basic
acidic
acidic = high or low pH?
alkaline/basic = high or low pH?
low
high
neutral normal range for pH in blood
7.35-7.45
T/F
acid-base balance can affect:
1. electrolytes = Na, K, Cl
2. hormones
3. oxygen transport and delivery (hgb)
- T
- T
- T
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
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
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
- 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)
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
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
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
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
Functions of _________:
- helps maintain cell membrane
- Helps with enzyme activity
- Part of H2O
- Keeps body hydrated
- Helps with energy production
Hydrogen
2 types of acids in the body
volatile and non volatile
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
Volatile acids
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)
Nonvolatile acids
is alkalosis or acidosis more difficult to correct
- avoid alkalosis (high pH/low hydrogen) – especially if person is ill , bc hgb hold onto O2 more, wont oxygenate tissue
General cause of imbalance is either metabolic or respiratory
- if HCO3/bicarb levels change = 2ndary to _________
- if H2CO3/carbonic acid level changes = 2ndary to _____________
metabolic/kidneys
respiratory/lungs
Primary disorder vs Primary event
____________ – the problem that initiates the acid-base imbalance
______________ – what results from the primary event
Primary event
Primary disorder
Primary disorder vs Primary event
hypoventilation = respiratory acidosis
vomiting = metabolic alkalosis
Primary event (hypoventilation) = primary disorder (respiratory acidosis)
Primary event (vomiting) = primary disorder (metabolic alkalosis)
__________ acidosis or alkalosis
- increase or decrease in CO2
- changes in ventilation
_________ acidosis or alkalosis
- changes in H ion or bicarb ions
Respiratory
Metabolic
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?
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
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)
Metabolic acidosis
to compensate kidneys can:
- Can eliminate large amounts of ______ (except carbonic acid)
- Can eliminate ______ (body excretes bicarb)
- can conserve and produce ________
- 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
Metabolic acidosis
expected ABGs before compensation
high, low, WNL
pH =
paCO2 =
HCO3 =
pH = <7.35 LOW acidic
paCO2 = 35-45 WNL
HCO3 = <24 LOW
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
metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkalosis
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
respiratory alkalosis
respiratory acidosis
metabolic alkalosis
metabolic acidosis
high pH and HCO3 increases
due to
- too much bicarb (base)
- not enough carbonic acid
Metabolic alkalosis
Metabolic alkalosis
expected ABGs before compensation high, low, WNL
pH =
paCO2 =
HCO3 =
pH = >7.48 HIGH basic
paCO2 = 35-45
HCO3 = >29 HIGH
Low pH and high CO2
due to
- too much retention of CO2 in lungs
- H2CO3 (carbonic acid) excess in ECF
Respiratory acidosis
can be acute or chronic
Respiratory acidosis
expected ABGs before compensation high, low, WNL
pH =
paCO2 =
H2CO3 = (with acute)
pH = < 7.35 LOW acidic
paCO2 = >45 HIGH acidic
H2CO3 = 24-29 WNL (with acute)
Respiratory alkalosis
expected ABGs before compensation high, low, WNL
pH =
paCO2 =
H2CO3 =
ABGs
pH = >7.45 HIGH basic
paCO2 = <35 LOW basic
H2CO3 = 24-29 WNL
high pH and low CO2
due to:
- too much loss of CO2 from lungs
- H2CO3 (carbonic acid) deficit in ECF
Respiratory alkalosis
high pH and low CO2
Low pH and high CO2
high pH and high HCO3
low pH and low HCO3
Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
Metabolic acidosis
(3) Acid-base balance/homeostasis systems
- buffers
- respiratory system
- renal system
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
- Buffers
bicarbonate-carbonic acid buffer system
location =
ECF
Acid-base balance/homeostasis systems: bicarbonate-carbonic acid buffer
The chemical equilibrium:
___ + ____ ⇌ _______ ⇌ ____ + ____
The chemical equilibrium:
CO2 + H2O ⇌ H2CO3 ⇌ H+ + HCO3-
carbon dioxide
water
Carbonic Acid
hydrogen ion (pH)
Bicarb
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
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
Acid-base balance/homeostasis systems: bicarbonate-carbonic acid buffer
______ _______ = breaks down carbonic acid
Carbonic anhydrase
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
raises
raises
very acidic levels/ low pH
sodium bicarb - raises pH
sodium bicarb - raises or lowers pH?
treats acidosis or alkalosis?
raises pH
acidosis
Acid-base balance/homeostasis systems: bicarbonate-carbonic acid buffer
how the lungs compensate for acidosis:
- When pH is _____ (more acidic and high hydrogen): body needs to get rid of _____
- Excess H+ ions combine with bicarbonate ions to form _________.
- Carbonic acid then dissociates into _____ and ______.
- The lungs expel the excess CO2, thereby reducing the acidity (___crease pH and __crease hydrogen)
- When pH decreases (more acidic and high hydrogen): body needs to get rid of hydrogen
- Excess H+ ions combine with bicarbonate ions to form carbonic acid.
- Carbonic acid then dissociates into CO2 and H2O.
- The lungs expel the excess CO2, thereby reducing the acidity (increase pH and lowering hydrogen)
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
Phosphate
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
protein and hemoglobin
gives up
Accepts
Picks up/accepts
Cellular compensation: Part of the buffer system
- Cells like to have a neutral charge
- H+ ions = positive
- K+ ions = positive (mostly found inside cell)
- When the body is acidic, theres a ___crease in H ions
- H ions move ____ cell
3.there is now too many positively charged ions in the cell - K moves ____ cell
- there is now too much K+ in the _____
- the ____ is neutral, but the ______ is hyperkalemic (dysrhythmias)
- the kidneys (if working) will excrete the excess ____
- K+ will ______ cell as pH returns to normal
- 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 __________
- When there is an increase in H ions (pH decreases/acidic increases)
- H ions move into cell
3.there is now too many positively charged ions in the cell - K moves out of the cell
- there is now too much K+ in the blood
- the cell is neutral, but the blood is hyperkalemic (dysrhythmias)
- the kidneys (if working) will excrete the excess K+
- K will go back into cell as pH returns to normal
- 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+
Acid-base balance/homeostasis systems: Respiratory mechanisms
Body makes CO2
CO2 + H2O ⇌ H2CO3
carbon water Carbonic
dioxide Acid
exhalation excretes_________
- does this affect fixed/non-volatile acids such as lactic acid?
- the body can adjust pH by changing _____ and ________
- if acidic (low pH/high hydrogen) = ___creased RR and depth = exhale more CO2
- if alkaline/basic (high pH/low hydrogen) = __crease RR and depth = hold onto more CO2
carbonic acid
- no
- rate and depth of breathing
- increase
- decrease
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)
- kidney excretion
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 ________
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
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
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
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
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
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)
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
If underlying problem is metabolic (kidneys) = __________ compensation can help (within ________)
- ______________
- ______________
respiratory (lung)
mins-hours
- hyperventilation
- hypoventilation
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
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
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 ________)
lung
min - hours
alkalosis
acidosis
HCO3/bicarb
If underlying problem is respiratory (lungs) = ____________ compensation can help (within _________)
If underlying problem is respiratory (lungs) = metabolic (kidneys) compensation can help (within hours to days)
- renal mechanism
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
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
Respiratory alterations = Respiratory acidosis/alkalosis = ______ compensation (within ______):
- __________ H2CO3/bicarb = acidosis correction
- __________ H2CO3/bicarb = alkalosis correction
Respiratory alterations = Respiratory acidosis/alkalosis = kidney compensation (in hours-days):
- conserving/reabsorbing H2CO3/bicarb = acidosis correction
- excreting H2CO3/bicarb = alkalosis correction
Normal values
pH =
CO2 =
pO2 =
HCO3 =
O2 sat =
24-29
7.35-7.45
35-45
95-100%
80-100
Normal values
pH = 7.35-7.45
CO2 = 35-45
pO2 = 80-100
HCO3 = 24-29
O2 sat = 95-100%
Normal values
pH =
CO2 =
pO2 =
HCO3 =
O2 sat =
Normal values
pH = 7.35-7.45
CO2 = 35-45
pO2 = 80-100
HCO3 = 24-29
O2 sat = 95-100%
_____________
Purpose
- assess acid base status
- determine adequacy of oxygenation and ventilation
which is more accurate ABG or VBG?
Arterial Blood Gas
ABG
_____ 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)
ABG
VBG
BMP
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
ABG
VBG
ABG
VBG
ABG
VBG
Tells you partial pressure of CO2 in
the vein
tells you the partial pressure of CO2
in artery
PvCO2 = 41-51 (VBG)
PaCO2 = 35-45 (ABG)
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)
- see if PCO2 is normal or abnormal
________ = not a respiratory problem
________ = respiratory problem (ROME = pH and PCO2 arrows will be _____ direction) - see if HCO3 is normal or abnormal
_________ = not a metabolic problem
_________ = metabolic problem (ROME = pH and HCO3 arrows will be _____ direction) - 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
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)
- see if PCO2 is normal or abnormal
normal = not a respiratory problem
abnormal = respiratory problem (ROME = pH and PCO2 arrows will be opposite direction) - see if HCO3 is normal or abnormal
normal = not a metabolic problem
abnormal = metabolic problem (ROME = pH and HCO3 arrows will be same direction) - 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
interpreting ABGs
1.
pH = 7.26
CO2 = 63
HCO3 = 24
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)
interpreting ABGs
2.
pH = 6.95
CO2 = 30
HCO3 = 5
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)
interpreting ABGs
3.
pH = 7.43
CO2 = 78
HCO3 = 42
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)
- hyperventilation causes respiratory acidosis or alkalosis
- hypoventilation causes respiratory acidosis or alkalosis
Causes of respiratory alkalosis
- hyperventilation (blowing off too much CO2)
Causes of respiratory acidosis
- hypoventilation (retains too much CO2)
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
metabolic acidosis
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
metabolic alkalosis
- CNS over excitability
s/s of acidosis or alkalosis - CNS depression
s/s of acidosis or alkalosis
alkalosis
acidosis
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?
Causes of respiratory acidosis
- hypoventilation (retains too much CO2)
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?
Causes of respiratory alkalosis
- hyperventilation (blowing off too much CO2)
