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Flashcards in 2. Acid-Base Deck (40):
1

pH

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

2

Reflection of the balance between carbonic acid and bicarbonate

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)

3

respiratory system acidosis

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

4

respiratory system alkalosis

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

5

Renal system acidosis

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.

6

renal system alkalosis

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)

7

pH normal*

7.35-7.45

8

pH decreased*

Acidosis

9

pH increased*

Alkalosis

10

pCO2 normal*

35-45

11

pCO2 decreased*

Alkalosis

12

pCO2 increased*

Acidosis

13

HCO3 normal*

22-26

14

HCO3 decreased*

Acidosis

15

HCO3 increased*

Alkalosis

16

pO2 normal*

80-100

17

pO2 decreased*

hypoxemia

18

pO2 increased*

O2 therapy

19

SaO2 normal*

85-100%

20

SaO2 decreased*

hypoxemia

21

metabolic acidosis

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

22

metabolic acidosis caused by direct

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

23

metabolic acidosis causes

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

24

metabolic acidosis s/s

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

25

metabolic acidosis treatment

bicarb, through IV, monitor K level closely
o chronic state: pts with renal failure may need hemodialysis

26

Metabolic alkalosis

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

27

Metabolic alkalosis causes

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

28

Metabolic alkalosis most common cause

vomiting, GI suctioning

29

Metabolic alkalosis s/s

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

30

Metabolic alkalosis treatment

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

31

respiratory acidosis

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

32

respiratory acidosis is an

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

33

respiratory acidosis s/s

- 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)

34

respiratory acidosis treatment

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

35

respiratory acidosis causes

Hypoventilation, CNS depression, Headache, tachycardia, diaphoresis

36

Respiratory alkalosis

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

37

Respiratory alkalosis causes

Hyperventilation, gram-negative bacteremia, respiratory stimulation

38

Respiratory alkalosis most common caused by

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

39

Respiratory alkalosis s/s

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

40

Respiratory alkalosis treatment

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