2. Acid-Base

Question 1

pH

Answer 1

Hydrogen (indirect measurement of hydrogen ion concentration)
• the greater concentration of H ion more acidic and the lower the pH; less concentration more alkaline and the higher the pH
• anything 6.8-7.8 = no life

Question 2

Reflection of the balance between carbonic acid and bicarbonate

Answer 2

carbonic acid: exhalable; results from aerobic metabolism of glucose (acid regulated by the lungs) and bicarbonate: nonexhalable; results from aerobic metabolism of fats and proteins and anaerobic metabolism of glucose (base regulated by the kidneys)

Question 3

respiratory system acidosis

Answer 3

you increase respiratory rate (hyperventilation) you eliminate, “blow off,” CO2 (acid) therefore decreasing your CO2 acid—giving you ALKLAOSIS by reducing acid

Question 4

respiratory system alkalosis

Answer 4

you decrease your respiratory rate (hypoventilation) you retain CO2 (acid) therefore increasing your CO2 (acid)—giving you ACIDOSIS by increasing acid load

Question 5

Renal system acidosis

Answer 5

You have Acidosis when you have excess H+ and decreased HCO3- causing a decrease in pH. The Kidneys try to adjust for this by excreting H+ and retaining HCO3- base.

Question 6

renal system alkalosis

Answer 6

You have Alkalosis when H+ decreases and you have excess (or increased) HCO3- base. The kidneys excrete HCO3- (base) and retain H+ to compensate. The respiratory system tries to compensate with hypoventilation to retain CO2 (acid)

Question 7

pH normal*

Answer 7

7.35-7.45

Question 8

pH decreased*

Answer 8

Acidosis

Question 9

pH increased*

Answer 9

Alkalosis

Question 10

pCO2 normal*

Answer 10

35-45

Question 11

pCO2 decreased*

Answer 11

Alkalosis

Question 12

pCO2 increased*

Answer 12

Acidosis

Question 13

HCO3 normal*

Answer 13

22-26

Question 14

HCO3 decreased*

Answer 14

Acidosis

Question 15

HCO3 increased*

Answer 15

Alkalosis

Question 16

pO2 normal*

Answer 16

80-100

Question 17

pO2 decreased*

Answer 17

hypoxemia

Question 18

pO2 increased*

Answer 18

O2 therapy

Question 19

SaO2 normal*

Answer 19

85-100%

Question 20

SaO2 decreased*

Answer 20

hypoxemia

Question 21

metabolic acidosis

Answer 21

Decrease pH (lower than 7.35), decrease HCO3 (lower than 22) (If PaCO2 decreased then compensating)

Question 22

metabolic acidosis caused by direct

Answer 22

direct loss of bicarb (too much acid, too little bicarb)

Question 23

metabolic acidosis causes

Answer 23

increase H production(DKA, hyper-metabolism)
decrease H elimination (renal failure)
decrease HCO3 production (dehydration, liver failure)
increase HCO3 elimination (diarrhea, fistulas

Question 24

metabolic acidosis s/s

Answer 24

o Associate with: diarrhea, diuretics, TPN, DKA, early renal insufficient, excessive chloride
o Symptoms: headache, drowsiness, pherial vasodilaiton especially pH below 7, drop in blood pressure, cold clammy, dysrythemia, shock

Question 25

metabolic acidosis treatment

Answer 25

bicarb, through IV, monitor K level closely

o chronic state: pts with renal failure may need hemodialysis

Question 26

Metabolic alkalosis

Answer 26

increase pH (above 7.45) increase bicarb (above 26)

Question 27

Metabolic alkalosis causes

Answer 27

increase bicarb (anatacids, admin of Na bicarb)
decreaes H (NG suctioning, vomitting, hypercortisolism)

Question 28

Metabolic alkalosis most common cause

Answer 28

vomiting, GI suctioning

Question 29

Metabolic alkalosis s/s

Answer 29

related to hypocalcemia; tingling fingers and toes, n/v/d, dizziness, anxious, seizures, hypertonic muscles, tremors, muscle cramping, low calcium levels, dysrhythmias

Question 30

Metabolic alkalosis treatment

Answer 30

correct underlying cause, monitor I&O carefully, may give sodium chloride (NS), treat low K – done with K/Chloride mixture, give tagament

Question 31

respiratory acidosis

Answer 31

Decrease pH (less 7.35), increase PaCO2 (greater than 48)

Question 32

respiratory acidosis is an

Answer 32

emergency inadequate ventilation, examples (pumeono thorax, overdose, obstructive sleep apnea, pulmonary edema, excessive O2, prolonged bed rest where actelsis, improper ventilator symptoms)

Question 33

respiratory acidosis s/s

Answer 33

• At first: increase heart rate, increase respirations, increase blood pressure, mental cloudiness, PCO2 great than 60
• As progresses – respirations shallow, headache, elevated K, ventricular fiblar, capillary edema, dilated blood vessels
• Chronic state: COPD (milder symptoms)

Question 34

respiratory acidosis treatment

Answer 34

improve ventilation – bronchilodilators, antibiotics – infection, thrombolytics; pulmonary hygeiene, incourage fluids to keep secretions thin – 2-3L per day, O2 as needed mechanical ventilation, gradual CO2 drop, high semi flowlers position

Question 35

respiratory acidosis causes

Answer 35

Hypoventilation, CNS depression, Headache, tachycardia, diaphoresis

Question 36

Respiratory alkalosis

Answer 36

Increase pH (greater 7.45), decrease PaCO2 (less than 35)

Question 37

Respiratory alkalosis causes

Answer 37

Hyperventilation, gram-negative bacteremia, respiratory stimulation

Question 38

Respiratory alkalosis most common caused by

Answer 38

most caused by hyperventilation – decrease carbonic acid, anxiety, hypocemia, aspirin toxicity, gram negative bacteria, inaprpriate ventialar settings

Question 39

Respiratory alkalosis s/s

Answer 39

respirations increase and deep, decrease blood pressure, low K, numbness, tingling, light headedness, inability to concentrate, COC, riging in ear

Question 40

Respiratory alkalosis treatment

Answer 40

slow down respirations, breath in paper bag, sedatives treat underlying cause