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FOUNDATIONS 310 > Acid/Base > Flashcards

Acid/Base Flashcards

1
Q

Functions of acid base balance?

A

homeostasis of body fluids, kidneys, and lungs

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2
Q

what controls Co2?

A

Respiratory process

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3
Q

what controls bicarbonate?

A

kidneys (metabolic process)

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4
Q

Carbons dioxide mixes with water to formwhat?

A

carbonic acid?

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5
Q

bicarbonate and hydrogen ions mix to form what?

A

carbonic acid

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6
Q

2 ways to make carbonic acid

A

co2+ h2o

Hco3 + hydrogen ions

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7
Q

what do you need to make carbonic acid in both processes?

A

carbonic anhydrase

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8
Q

what controls breathing?

A

Co2

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9
Q

how quickly does respiratory system respond to acid base changes?

A

quickly- within minutes

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10
Q

is bicarb an acid or a base?

A

base

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11
Q

is Co2 an acid or a base?

A

acid

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12
Q

the kindeys control acid-base balance through the retention or excretion of what 2 substances?

A

hydrogen ions and bicarbonate ions

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13
Q

how quickly does the renal systems respond to acid base changes?

A

hours to days

-slower than resp but stronger response

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14
Q

how do we figure out acid base status?

A

ABG -arterial blood gas

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15
Q

most common artery for ABG

A

radial or femoral

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16
Q

pH range

A

7.35-7.45

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17
Q

PaCo2 ranges

A

35-45 mmHg

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18
Q

HCO3 ranges

A

22-26 mEq/L

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19
Q

Co2 < then 35 =

A

base

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20
Q

Co2 > 45 =

A

acid

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21
Q

HCO3 <22=

A

acid

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22
Q

HCO3 >26=

A

base

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23
Q

If pH is below 7.35 body will compensate to what range?

A

7.35-7.39

24
Q

if pH is above 7.45 body will adjust to

A

7.41-7.45

25
Q

when does an UNcompensated acid-base disorder occur?

A

CO2 or HCO3 = abnormal

pH = normal

26
Q

when does a PARTIALLY compensated acid-base disorder occur

A

CO2, HCO3, pH are abnormal

27
Q

compensated acid-base disorder occurs when

A

CO2 + HCO3= abnormal

pH = normal

28
Q

4 types of uncompensated acid-base disorders

A

metabolic acidosis/alkalosis

respiratory acidosis/alkalosis

29
Q

causes of metabolic acidosis

A

-excess carbonic acid productions or bicarb deficit: DKA, lactic acid accumulation with anaerobic exercise, renal disease, severe diarrhea

30
Q

how does severe diarrhea cause metabolic acidosis ?

A
  • dehydration lead to build up of lactic acid or shock

- stool contains bicarb and severe diarrhea means prolonged loss of bicarb

31
Q

how does kidney disease cause metabolic acidosis?

A

kidneys make bicarb so not making enough bicarb

32
Q

metabolic acidosis compensation

A
  • kidneys make more bicarb

- respiratory hyperventilation to blow off CO2

33
Q

what is problem with hyperventilation to treat metabolic acidosis?

A
  • resp compensation is relatively weak

- underlying problem is not addressed

34
Q

s/s metabolic acidosis

A
  • kassmaul’s respiration
  • lethargy, fatigue, coma
  • hypertension, dysrhythmias
  • hyperkalemia
35
Q

what are kussmaul’s respirations?

A

deep rapid resps with metabolic acidosis

36
Q

why have hyperkalemia with metabolic acidosis?

A

H and K have same 1+ charge so they swap places in the cell
potassium –> out into intravascular
hydrogen –> in to intracellular
–see increase in serum potassium

37
Q

metabolic acidosis treatment

A

kidney impairment –> hemodialysis
DKA –> insulin
shock –> fluid replacement/shock treatment

38
Q

what can be done to treat hyperkalemia?

A

insulin + dextrose, loop diuretics

39
Q

metabolic alkalosis causes

A
  • base bicarb excess
  • prolonged vomiting / gastric suction (loss of hydrochloric acid)
  • bicarb gain
40
Q

who would be taking bicarbonate supplements and thus be at risk for metabolic alkalosis?

A

patients with renal insufficiency

41
Q

metabolic alkalosis compensation

A
  • renal excretion of bicarb

- decrease resp rate (occurs first)

42
Q

Metabolic alkalosis s/s

A
  • hyperactive reflexes
  • paresthiesia
  • tetany
  • seizures
  • resp. depression
  • hypocalcemia, hypokalemia
43
Q

metabolic alkalosis treatment

A
  • for vomiting/gastric suctioning –> adequate hydration, arginine hydrochloride (raises chloride level)
  • diuretic: diamox
44
Q

how does arginine hydrochloride treat metabolic alkalosis?

A

raises chloride levels which are reduced from gastric loss

45
Q

what is diamox? how does it help metabolic alkalosis treatment?

A

carbonic anhydrase inhibitor

  • carbonic anhydrase turns bicarb to turn into carbonic acid
  • if inhibited –> bicarb no go carbonic acid –> excreted instead
46
Q

hypoventilation is < ____ resps/minute

A

12

47
Q

causes of respiratory acidosis

A
  • hypoventilation
  • resp failire
  • injury to medulla
  • overdose of benzo/opioids (anything with sedative effect)
48
Q

how does medulla injury cause respiratory acidosis?

A
  • medulla is CNS control of respirations

- if no fxn then result in hypoventilation

49
Q

respiratory acidosis compensation

A
  • will only have metabolic renal compensations

- -> kidneys retain bicarb ions or excrete H ions

50
Q

respiratory acidosis s/s

A

mental status change may occur 1st

  • ->irritability, disorientation, lethargy, coma, headache
  • tachycardia
51
Q

why have tachycardia with respiratory acidosis?

A

trying to get more O2

52
Q

respiratory acidosis treatment

A
  • -priority it treat underlying cause
  • –obstructive condition –> Bipap or mechanical ventilation
  • –sedative overdose –> narcan (naloxone)
  • O2, HOB elevated, antibiotics in pneumonia
53
Q

respiratory alkalosis causes

A

-acid deficit caused by hyperventilation or pulmonary disorders
rapid breathing: anxiety, fever, pain, traums, anemia, asthma, PE, CVA

54
Q

respiratory alkalosis compensation

A

bicarb shifts INTO cells in exchange for CHLORIDE ions

-if alkalosis persists –> renal excretion of bicarb

55
Q

resp alkalosis s/s

A

neuromuscular: paraesthesia, dizziness, vertigo, tetany
CV: tachy, dysrhythmias, sweating

56
Q

Resp Alkalosis treatment

A
  • pain/anxiety –> intervention for that
  • asthma –> bronchodilator
  • anemia –> packed red blood cells, restore Hgb
57
Q

how is bicarbonate made?

A

carbonic acid dissociates in the kidneys to make a hydrogen ion and bicarbonate

FOUNDATIONS 310 (28 decks)

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