Acid-Base Balance

Question 1

Major chemicals involved in acid-base balance

Answer 1

Bicarb (base)
Hydrogen (acid)
CO2 (acid)

Question 2

Major lung chemical

Answer 2

CO2

Question 3

Kidney chemicals

Answer 3

Bicarb and hydrogen

Question 4

Respiratory acidosis:
This is a (lung or kidney) problem.
What chemical is causing the problem?
Too much or not enough of this chemical?
Hypo- or hyperventilating?
Who is going to compensate? How?

Answer 4

Lung
CO2
Too much
Hypoventilating
Kidney, retain bicarb (base) and excrete H (acid)

Question 5

What are some causes of respiratory acidosis?

Answer 5

Mid abdominal incision
Narcotics (decreased RR)
Sleeping pills
Pneumothorax
Collapsed lung
Pneumonia

Question 6

Normal values:
pH
PaO2
PaCO2
HCO3

Answer 6

pH –> 7.35 - 7.45
PaO2 –> 80 - 100
PaCO2 –> 35 - 45
HCO3 –> 22 - 26

Question 7

S/S of Respiratory Acidosis

Answer 7

Confusion (decreased LOC, 1st sign)
HA
Sleepy

Question 8

Restlessness, think ___ first

Answer 8

hypoxia

Question 9

If Resp Acidosis not corrected, could lead to a ___

Answer 9

coma

Question 10

If hypoxic, give ___

Answer 10

oxygen

Question 11

Early S/S of hypoxia?

Answer 11

restlessness

tachycardia

Question 12

Treatment of Resp acidosis

Answer 12

• fix the respiratory problem

- encourage post-op clients to turn, cough, deep breathe

Question 13

Respiratory alkalosis:
Which organ is sick? Why?
Which organ will compensate? How?

Answer 13

lungs, breathing off too much CO2

kidneys, excrete bicarb (base) and retain H (acid)

Question 14

Causes of respiratory alkalosis?

Answer 14

hyperventilation from…

• hysterical
• acute ASA overdose

Question 15

S/S of resp alkalosis

Answer 15

lightheaded / faint feeling
peri-oral numbness
numbness and tingling in fingers and toes

Question 16

Treatment of resp alkalosis

Answer 16

Breathe into paper bag
May have to sedate (decreases RR)
Treat the cause
Monitor ABGs

Question 17

Metabolic acidosis:
What organ is sick? Why?
Respiratory rate will (increase or decrease)?

Answer 17

kidneys, too little bicarb and too much H+

Increase, to blow of excess acid

Question 18

Causes of metabolic acidosis

Answer 18

DKA
Starvation
Renal failure
Severe diarrhea

Question 19

What electrolyte is elevated with metabolic acidosis? Why?

Answer 19

K+

B/c of H-K pump; when cells take up H+, they spit out K+

Question 20

S/S of hyperkalemia associated with metabolic acidosis?

Answer 20

muscle twitching
muscle weakness
flaccid paralysis
arrhythmias

Question 21

Metabolic alkalosis:

What organ is sick? Why?

Answer 21

Kidneys, too much bicarb (base), not enough H+ (acid)

Question 22

Causes of metabolic alkalosis

Answer 22

Loss of upper GI contents (vomiting too much acid)
Too many antacids (base)
Too much IV bicarb

Question 23

S/S of metabolic alkalosis

Answer 23

LOC
Hypokalemia
Muscle cramps
Life-threatening arrythmias

Question 24

Treatment of metabolic alkalosis

Answer 24

Fix the problem

Replace K+