Acid Base Imbalance Flashcards
Acid-Base Balance of 3:
Want to have a balance of the following three things:
- pH: % of hydrogen ions in a solution as well as acids and bases
- acids: give up or donate H+ (i.e. carbonic acid H2CO3)
- acids are continually produced during normal metabolism
- bases: accept H ions (i.e. bicarbonate (HCO3)
- bases neutralize and promote excretion fo those acids to maintain pH balance
Acidosis:
pH < 7.35
increased H+ concentration = acidity
Alkalosis Range:
pH > 7.45
decreased H+ concentration = alkalinity
Acid Base Imbalance: Causes
DM Cancer COPD, tissue hypoxia Renal disease Trauma medications (diuretics, steroids, TPN) Prolonged vomiting, diarrhea, GI suction, malnutrition
Regulation of Acid-Base Balance: 1
Buffers:
fastest but not long action
primary regulators - bicarbonate, phosphate, and proteins (these chemicals bind to and neutralize acid need intact renal and respiratory systems to work efficiently
all body fluids contain buffers. When you look at ECF, an in crease in H+ ions may change hydrogen for potassium
- acidosis = elevated K
- alkalosis = lower K
Carbonic acid and bicarbonate: buffer blood and IF
Phosphates: reach with acids and bases to form compounds that alter pH
Proteins: inside and outside cells (intra and extra cellular) bind with acids and bases to alter pH
Regulation of Acid-Base Balance: 2
Respiratory System:
responds in minutes (kicks in after buffer system has kicked in)
max effect seen in a couple hours
excrete CO2 and H2O (biproducts of cellular metabolism)
increased respirations (hyperventilation): decreases plasma CO2 (less carbonic acid and less H+ ions)
decreased respirations (hypoventilation): increases plasma CO2 (increased carbonic acid and increased H+ ions)
Respiratory system must be intact to work efficiently
*if respiratory condition is cause of acid/base imbalance, it cannot regulate the pH. Cannot be the solution to the problem if it is the problem.
Regulation of Acid-Base Balance: 3
Renal System:
responds in 2-3 days but lasts longer than respiratory and buffer
excrete acid in urine
-kidneys will excrete or reabsorb H+ ions or bicarbonate
-test pH of urine which tells us how kidneys are responding to change in body pH
Renal system must be intact to be efficient.
*if renal problem is cause of imbalance, it cannot regulate pH and cannot be the solution to the problem if it’s causing the problem.
Symptoms of Respiratory Acidosis
hyperventilation leading to hypoxia decreased BP with vasodilation dyspnea HA Hyperkalemia Drowsiness, dizziness, disorientation muscle weakness hyperreflexia
Respiratory Acidosis: Causes
Decreased respiratory stimuli (anesthesia, drug OD)
COPD
Pneumonia
Atelectasis
Symptoms of Respiratory Alkalosis
Hyperventilations Seizures Tachycardia Hypokalemia Numbness & tingling of extremities Lethargy and confusion N/V
Need to aggressively treat b/c symptoms can be fatal or lead to severe consequences
Respiratory Alkalosis: Causes
Hyperventilation (Anxiety, PE, Fear)
Mechanical Ventilation
Metabolic Acidosis: Symptoms
HA Decreased BP Hyperkalemia Muscle twitching warm, flushed skin N/V decreased muscle tone, decreased reflexes Kussmaul respirations
Metabolic Acidosis: Causes
Increased H+ production (DKA, hyper-metabolism)
Decreased H+ elimination (renal failure)
Decreased HCO3 production (dehydration, liver failure)
Increased HCO3 elimination (diarrhea, fistulas)
Metabolic Alkalosis: Symptoms
Restlessness followed by lethargy Dysrhythmias (tachycardia) compensatory hypoventilation Confusion (decreased LOC, dizzy, irritable) N/V Diarrhea Hypokalemia Tremors, muscle cramps, tingling of fingers and toes Hypokalemia
Acid Base Balance ABG Normal Values
pH: 7.35-7.45 (buffers)
PaCO2: 35-45 mmHg (respiratory system)
HCO3: 22-26 mEq/L (renal)
