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NURS 416 > Week 8a: acid base balance > Flashcards

Week 8a: acid base balance Flashcards

1
Q

normal pH

A

7.35-7.45

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2
Q

normal PaO2

A

80-100mmHg

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3
Q

normal PaCO2

A

35-45

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4
Q

HCO3

A

21-25mmol/L

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5
Q

Normal base excess

A

-2 - +2

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6
Q

high anion gap =

A

acidosis

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7
Q

base excess more than +2 =

A

metabolic alkalosis

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8
Q

base excess less than -2 =

A

metabolic acidosis

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9
Q

normal anion gap

A

8-16mmol/L

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10
Q

signs and symptoms of metabolic acidosis

A
  • increased respiratory rate and depth
  • acidic urine
  • weakness, fatigue, nausea and vomiting
  • later signs: decreased LOC, decreased CO, coma and death
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11
Q

for treatment of metabolic acidosis, why is sodium bicarbonate not always indicated?

A

it can cause hyperosmolarity and hypoxia

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12
Q

what is the primary disturbance in metabolic acidosis?

A

decrease in bicarbonate, DKA, sepsis, severe diarrhea, renal failure, shock

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13
Q

respiratory compensation in metabolic acidosis?

A

hyperventilation to decreased PCO2

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14
Q

renal compensation in metabolic acidosis?

A

if no renal disease, then increased H+ excretion and increased HCO3 reabsorption

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15
Q

what is the primary disturbance in metabolic alkalosis?

A

decrease in bicarbonate

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16
Q

respiratory compensation in metabolic alkalosis?

A

hypoventilation to increase PCO2

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17
Q

renal compensation in metabolic alkalosis?

A

if no renal disease, decrease in H+ excretion and decrease in HCO3 reabsorption

18
Q

what are the causes of metabolic alkalosis?

A

alkaline ingestion, gastric suction, hypokalemia, loss of body fluids (diuretics), high lactate (ringers lactate)

19
Q

signs and symptoms of metabolic alkalosis?

A

decreased respirations, hypotension, alkaline urine, confusion, convulsions, arrhythmias, tetany

20
Q

what is one of the main treatments for metabolic alkalosis?

A

sodium chloride (mild) or ammonium chloride (severe)

21
Q

what is the primary disturbance in respiratory acidosis ?

A

increase in PCO2

22
Q

is there respiratory compensation in respiratory acidosis?

A

no

23
Q

renal compensation in respiratory acidosis

A

increased H+ excretion and increased HCO3 reabsorption

24
Q

causes of respiratory acidosis?

A

lung disease (COPD, pulmonary edema), hypoventilation in hospitalized ventilated patients, bradypnea (drug overdose), sepsis, trauma (burns and head injury)

25
Q

signs and symptoms of respiratory acidosis?

A

changes in LOC, headache (due to vasodilation), confusion/paranoia/hallucinations (due to hypoxia), flushed skin (vasodilation)

26
Q

primary disturbance in respiratory alkalosis?

A

decrease in PCO2

27
Q

is there respiratory compensation in respiratory alkalosis?

A

no

28
Q

renal compensation in respiratory alkalosis

A

decreased H+ excretion and decreased HCO3 reabsorption

29
Q

causes of respiratory alkalosis?

A

hyperventilation due to increased mechanical ventilation, panic/anxiety, fever, encephalitis, compensation due to hypoxia and drug toxicity (ASA)

30
Q

a urine output of _____ may indicate hypovolemia

A

0.5mg/kg/h

31
Q

what are some signs of hypervolemia?

A

hypertension, bounding pulse, pulmonary crackles, dyspnea, SOB, peripheral edema, JVD and extra heart sounds such as S3

32
Q

which IV solution is the fluid of choice for resuscitation efforts?

A

normal saline

33
Q

which IV solution is used to replace fluid loss from hemorrhage, severe vomiting or diarrhea, heavy drainage from GI suctioning, fistulas or wounds?

A

normal saline

34
Q

which IV solution is the fluid of choice for resuscitation of burn and trauma patients?

A

ringers lactate

35
Q

Which IV solution is used to treat acute blood loss or hypovolemia due to 3rd space fluid shift; GI loss and fistula drainage, electrolyte loss and metabolic acidosis ?

A

ringers lactate

36
Q

which IV solution is both isotonic and hypotonic?

A

D5W

37
Q

which IV solution provides free water for the kidneys, aiding in renal excretion of solutes and may be used to treat hypernatremia

A

D5W

38
Q

which type of solutions are typically used to treat conditions causing intracellular dehydration such as DKA and hyperosmolar hyperglycaemic states

A

hypotonic

39
Q

what type of solutions may worsen existing hypovolemia and hypotension causing cardiovascular collapse?

A

hypotonic

40
Q

which type of solutions may be used to correct critical electrolyte abnormalities?

A

hypertonic

41
Q

which type of solutions may cause fluid volume overload and pulmonary edema

A

hypertonic

42
Q

which type of solutions should be avoided in patients with cardiac or renal conditions who are dehydrated and in patients with DKA?

A

hypertonic

NURS 416 (17 decks)

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