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perf tech 3 > 1. Acid/Base- Exam 1 > Flashcards

1. Acid/Base- Exam 1 Flashcards

1
Q

define an acid

A

Molecule containing hydrogen atom that can release hydrogen ion when placed in solution

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2
Q

what the difference between an strong and weak acid

A

Strong: Rapid dissociation with release large amount of H+ (HCl)
Weak: Slow dissociation with release small amount of H+ (H2CO3)

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3
Q

define a base

A

Ion or molecule that can accept hydrogen ions

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4
Q

whats the difference between a strong and weak base

A

Strong: Reacts strongly and rapidly with H+ and quickly removes larger quantities of H+ from solution (OH-)
Weak: Reacts slowly forming weak bonds does not remove as much H+ (HCO3-)

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5
Q

Most of the acids & bases in extracellular fluid involved with normal acid-base regulation are what kind of acids and bases?

A

weak acids and weak bases

–H2CO3 and HCO3-

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6
Q

Normal blood [H+] is?

A

40 nEq/liter

which is 0.00004 mEq/liter

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7
Q

what is the normal and extreme range for [H+]?

A

Normal variations 3 to 5 nEq/liter

Extreme range: 10 nEq/liter to 50 nEq/liter

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8
Q

pH= [formula]

A

log(1/[H+]) which equals -log[H+]

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9
Q

Levels at which person can live more than a few hours:
•Lower limit: ?
•Upper limit: ?

A
  • Lower limit: 6.8

* Upper limit: 8.0

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10
Q

what are the 3 buffer systems

A

–Bicarbonate system (extracellular)
–Phosphate system (extracellular)
–Proteins (intracellular)

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11
Q

what do the lungs and kidneys control

A

Lungs: Control of carbon dioxide
Kidneys: Control of hydrogen ion and bicarb ion concentration

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12
Q

Hbg Buffering is special because it can do what?

A

act as an acid or a base

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13
Q

Hgb buffering titration with an acid results in what?

A

Net charge of +3 and 1 H+ ion

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14
Q

Hgb buffering titration with a base results in what?

A

Net charge of -3 and 1 OH- ion and 3 H20 molecules

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15
Q

describe what happens on the hemoglobin titration curve if 1.15 mM of H+ is added

A

the pH decreases by 0.16 units

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16
Q

Henderson-Hasselbalch pH= [general formula]

A

pK + log ([base]/[acid])

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17
Q

Henderson-Hasselbalch pH= [formula for bicarb/co2 system]

A

pK + log ([bicarb]/[CO2]*0.0301)

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18
Q

what is the plasma pK at 37C

A

6.1

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19
Q

what is the only thing that will change pK?

A

temperature

as temp increases, pK decreases

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20
Q

what is the solubility for CO2 at 37C?

A

0.0301

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21
Q

changing respiratory components, changes what on the chart?

A

the pCO2 isobar

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22
Q

changing metabolic components, changes what on the chart?

A

the hemoglobin buffer line

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23
Q

HypOventilating causes ACIDosis- describe the changes in CO2, pH, H+, Bicarb, and Hgb

A 
CO2 INCREASE
pH DECREASE
H+ INCREASE
Bicarb INCREASE
Hgb INCREASE
-Reaction moves to the LEFT
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24
Q

HypERventilating causes ALKALosis- describe the changes in CO2, pH, H+, Bicarb, and Hgb

A 
CO2 DECREASE
pH INCREASE
H+ DECREASE
Bicarb DECREASE
Hgb DECREASE
-Reaction moves to the RIGHT
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25
Q

define alkalemia

A

basic blood
pH >7.45
as pH increases, CO2 decreases

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26
Q

define alkilosis

A

basic ‘condition’

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27
Q

define acidemia

A

acidic blood
pH <7.35
as pH decreases, CO2 increases

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28
Q

define acidosis

A

acidic ‘condition’

29
Q

describe what happens when the hgb buffer line moves up

A

metabolic changes- Alkilosis

Increased base= Decreased H+

30
Q

describe what happens when the hgb buffer line moves down

A

metabolic changes- Acidosis

Decreased base= Increased H+

31
Q

describe initial problem seen with metabolic acidosis

A

Buffer Line moves down the pCO2 isobar as [H+] increases and/or [HCO3-] decreases
–pH {DN}; [HCO3-] {DN}; pCO2 {NC}

32
Q

describe compensation seen with metabolic acidosis

A

pCO2 isobar moves to right along Buffer Line as CO2 is blown off
–pH {UP}; [HCO3-] {DN}; pCO2 {DN}

33
Q

describe the final result seen with metabolic acidosis

A

pH {DN}; [HCO3-] {DN}; pCO2 {DN}

34
Q

describe initial problem seen with respiratory acidosis

A

pCO2 isobar moves left along Buffer Line as pCO2 increases

–pH {DN}; [HCO3-] {UP}; pCO2 {UP}

35
Q

describe compensation seen with respiratory acidosis

A

Buffer Line moves up the pCO2 isobar as the kidney excretes hydrogen ions and retains bicarb
–pH {UP}; [HCO3-] {UP}; pCO2 {NC}

36
Q

describe the final result seen with respiratory acidosis

A

pH {DN}; [HCO3-] {UP}; pCO2 {UP}

37
Q

describe initial problem seen with metabolic alkalosis

A

Buffer Line moves up the pCO2 isobar as [H+] decreases and/or [HCO3-] increases
–pH {UP}; [HCO3-] {UP}; pCO2 {NC}

38
Q

describe compensation seen with metabolic alkalosis

A

pCO2 isobar moves to left along Buffer Line as CO2 is retained
–pH {DN}; [HCO3-] {UP}; pCO2 {UP}

39
Q

describe the final result seen with metabolic alkalosis

A

pH {UP}; [HCO3-] {UP}; pCO2 {UP}

40
Q

describe initial problem seen with respiratory alkalosis

A

pCO2 isobar moves right along Buffer Line as pCO2 decreases

–pH {UP}; [HCO3-] {DN}; pCO2 {DN}

41
Q

describe compensation seen with respiratory alkalosis

A

Buffer Line moves down the pCO2 isobar as the kidney retains hydrogen ions and removes bicarb
–pH {DN}; [HCO3-] {DN}; pCO2 {NC}

42
Q

describe the final result seen with respiratory alkalosis

A

pH {UP}; [HCO3-] {DN}; pCO2 {DN}

43
Q

After determining if the pH is acidic or basic, what do you look at next to determine if the primary cause is respiratory or metabolic?

A

bicarb

44
Q

If pH indicates acidosis
•Metabolic (bicarbonate concentration ____)
•Respiratory (bicarbonate concentration ____)

A

If pH indicates acidosis
•Metabolic (bicarbonate concentration LOW)
•Respiratory (bicarbonate concentration HIGH)

45
Q

If pH indicates alkalosis
•Metabolic (bicarbonate concentration ____)
•Respiratory (bicarbonate concentration ____)

A

If pH indicates alkalosis
•Metabolic (bicarbonate concentration HIGH)
•Respiratory (bicarbonate concentration LOW)

46
Q

After determining the primary cause is METABOLIC acidosis or alkalosis, to determine if there is a secondary cause: what value do you look at?

A

actual pCO2 value

47
Q

After determining the primary cause is RESPIRATORY acidosis or alkalosis, to determine if there is a secondary cause: what value do you look at?

A

actual bicarb value

48
Q

If the Primary Problem is Metabolic ACIDOSIS, what formula do you use to calculate the predicted value of compensated pCO2

A

pCO2 = (1.5 x [HCO3-]) + 8

49
Q

If the Primary Problem is Metabolic Acidosis, and you have calculated the predicted value of compensated pCO2…If OBSERVED pCO2 is more than 2 mmHg HIGHER than calculated pCO2 there is a good chance of secondary/coexisting __________

A

respiratory acidosis

50
Q

If the Primary Problem is Metabolic Acidosis, and you have calculated the predicted value of compensated pCO2…If OBSERVED pCO2 is more than 2 mmHg LOWER than calculated pCO2 there is a good chance of secondary/coexisting __________

A

coexisting respiratory alkalosis

51
Q

If the Primary Problem is Metabolic ALKALOSIS, what formula do you use to calculate the predicted value of compensated pCO2

A

pCO2 = 40 + (0.7 x ([HCO3-measured] - 24))

52
Q

If the Primary Problem is Metabolic ALKALOSIS, and you have calculated the predicted value of compensated pCO2..If OBSERVED pCO2 is more than 5 mmHg HIGHER than calculated pCO2 there is a good chance of secondary/coexisting ______

A

respiratory acidosis.

53
Q

If the Primary Problem is Metabolic ALKALOSIS, and you have calculated the predicted value of compensated pCO2..If OBSERVED pCO2 is more than 5 mmHg LOWER than calculated pCO2 there is a good chance of secondary/coexisting _______

A

respiratory alkalosis.

54
Q

_____ is the maximum pCO2 possible when compensating for metabolic alkalosis. A pCO2 higher means there is a __________

A

55 mmHg

coexisting respiratory acidosis

55
Q

If the Primary Problem is Respiratory ACIDOSIS, and the onset was LESS THAN 24 hrs, what equation do you use

A

ACUTE: 1 mEq/L increase in [HCO3-] for every 10 mmHg increase in pCO2

56
Q

If the Primary Problem is Respiratory ACIDOSIS, and the onset was MORE THAN 24 hrs, what equation do you use

A

CHRONIC: 3.5 mEq/L increase in [HCO3-] for every 10 mmHg increase in pCO2

57
Q

If the Primary Problem is Respiratory ACIDOSIS and you have calculated the predicted compensation value of bicarb… If OBSERVED [HCO3-] is MORE than the calculated [HCO3-] there is a good chance of secondary/coexisting _______

A

metabolic alkalosis.

58
Q

If the Primary Problem is Respiratory ACIDOSIS and you have calculated the predicted compensation value of bicarb… If OBSERVED [HCO3-] is LESS than the calculated [HCO3-] there is a good chance of secondary/coexisting _______

A

metabolic acidosis

59
Q

If the Primary Problem is Respiratory ALKALOSIS, and the onset was LESS THAN 24 hrs, what equation do you use

A

ACUTE: 2 mEq/L decrease in [HCO3-] for every 10 mmHg decrease in pCO2

60
Q

If the Primary Problem is Respiratory ALKALOSIS, and the onset was MORE THAN 24 hrs, what equation do you use

A

CHRONIC: 5 mEq/L decrease in [HCO3-] for every 10 mmHg decrease in pCO2

61
Q

If the Primary Problem is Respiratory ALKALOSIS and you have calculated the predicted compensation value of bicarb… If OBSERVED [HCO3-] is LESS than the calculated [HCO3-] there is a good chance of secondary/coexisting _______

A

metabolic acidosis

62
Q

If the Primary Problem is Respiratory ALKALOSIS and you have calculated the predicted compensation value of bicarb… If OBSERVED [HCO3-] is MORE than the calculated [HCO3-] there is a good chance of secondary/coexisting _______

A

metabolic alkalosis

63
Q

What is the formula and normal value for anion gap

A

AG = [Na+] – ([Cl-] + [HCO3-])

AG normal value = 9 to 16 mEq/L

64
Q

AG > 30 mEq/L indicates what?

A

–High anion gap metabolic acidosis

65
Q

AG > 20 mEq/L indicates what?

A

–probably high anion gap metabolic acidosis

66
Q

AG >=16 and <=20 mEq/L indicates what?

A

–abnormal but may be due to variety things other than anion gap acidosis

67
Q

Not all acidosis should be treated with bicar- BUT If the pH is below ____ bicarb should be given regardless of cause

A

7.10

68
Q

What is the formula to calculate how much bicarb to give if there is a deficit

A

HCO3-deficit = .5 x Body Weight (kg) x ([HCO3-(desired)] – HCO3-(measured)])

perf tech 3 (15 decks)

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