ACID BASE DISTURBANCES Flashcards

1
Q

Indicator of H+ Concentration, reflects acidity or alkalinity in blood

A

Plasma pH

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2
Q

Normal plasma PH is

A

7.35-7.45

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3
Q

What are the plasma PH homeostatic mechanisms?

A

-Buffer System
- Kidneys
- Lungs

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4
Q

Prevents major changes in the pH of body fluids

A

Buffer System

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5
Q

Carbonic acid buffer system

A

Bicarbonate

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6
Q

Removes or releases H+

A

Buffer System

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7
Q

What is the ratio of bicarbonate to carbonic acid buffer system

A

20:1

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8
Q

It is regulated by the kidneys

A

Bicarbonate (HCO3)

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9
Q

It is regulated by the lungs

A

Carbonic Acid

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10
Q

Regulate the bicarbonate level in the ECF

A

Kidneys

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11
Q

Able to regenerate bicarbonate ions and/or reabsorb the ions from the renal tubular cells

A

Kidneys

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12
Q

A base bicarbonate deficit

A

Metabolic Acidosis

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13
Q

Occurs when an acid other than carbonic acid accumulates in the body or when bicarbonate is lost from body fluids.

A

Metabolic Acidosis

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14
Q

What are the causes of metabolic acidosis? (DSLR)

A

-Diabetes Ketoacidosis
-Severe diarrhea
-Lactic acidosis
- Renal disease

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15
Q

Clinical Manifestations of Metabolic Acidosis

A

-Kussmaul respiration (deep, rapid breathing)
- Peripheral vasodilation (warm, flushed skin)
- Hypotension
- Hyperkalemia
- Dysrhythmia
- N&V
- Headache
-Drowsiness
-Confusion
-Coma

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16
Q

Why fluid replacement is important in the collaborative management of metabolic acidosis?

A

because water loss may result from hyperventilation

17
Q

What drugs are appropriate for metabolic acidosis?

A

Sodium bicarbonate

18
Q

A base bicarbonate excess

A

Metabolic Alkalosis

19
Q

Occurs when a loss of acid or gain in bicarbonate occurs

A

Metabolic Alkalosis

20
Q

Causes of Metabolic Alkalosis? (SPEED)

A

-Severe vomiting
- Potassium deficit
-Excessive gastric suction
- Excess sodium bicarbonate suction
- Diuretic therapy

21
Q

Clinical Manifestations of Metabolic Alkalosis

A

Hypoventilation
Tachycardia
Hypokalemia
Dysrhythmia
Tetany
Seizures
Dizziness
Confusion
Headache

22
Q

What happens when hypocalcemia develops as alkalosis damages ionized calcium?

A

Tetany

23
Q

What solutions must be administered in metabolic alkalosis?

A

Administer sodium chloride solutions

24
Q

Drugs for Metabolic Alkalosis

A

-Cimetidine (Tagamet)
- Acetazolamide (Diamox)

25
Q

H2 receptor agonist and reduces the production of gastric hydrogen chloride

A

Cimetidine (Target)

26
Q

Carbonic anhydrase inhibitor and increases excretion of bicarbonate by the kidneys

A

Acetazolamide (Diamox)

27
Q

A carbonic acid excess

A

Respiratory Acidosis

28
Q

Occurs when a person hypoventilates

A

Respiratory Acidosis

29
Q

What are the causes of respiratory acidosis? (SCAN COMB)

A

Severe pneumonia
COPD
Atelectasis
Neuromuscular disorders
Chest wall abnormalities
Opioid overdose
Mechanical hypoventilation
Barbiturate overdose

30
Q

Respiratory Acidosis Clinical Manifestations

A

-Tachycardia, tachypnea
-Increased BP
- Confusion
-Feeling of fullness in the head
- Decreased LOC

31
Q

The appropriate position in respiratory acidosis is

A

Semi-fowlers postion

32
Q

Carbonic acid deficit

A

Respiratory Alkalosis

33
Q

Occurs with hyperventilation

A

Respiratory Alkalosis

34
Q

Hyperventilation manifests:

A

-Hypoxia
-Pulmonary embolism
- Anxiety
- Fear
-Pain
- Exercise
-Fever

35
Q

Respiratory Alkalosis Clinical Manifestations

A

-Dizziness
-Confusion
-Headache
-Tachycardia
-Dysrhythmia
- Hypokalemia
-Nausea and vomiting
- Epigastric Pain
- Tetany
-Seizures

36
Q

Nursing responsibilities when the patient experiences hyperventilation

A

Let the patient breath into paper bag or cupped hands