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Pathophysiology > AC Imbalance > Flashcards

AC Imbalance Flashcards

1
Q

metabolism requires precise balance of acid and base in the body, which is reflected by?

A

the pH of extracellular fluid

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2
Q

What depends on a regulated pH?

A

membrane excitability, enzyme systems, chemical reactions

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3
Q

High concentration of H+ ions =

A

low pH & acidosis

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4
Q

Low concentration of H+ ions =

A

high pH & alkalosis

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5
Q

What is the body’s normal pH?

A

7.35-7.45

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6
Q

If AC imbalance is not corrected, what mechanisms will attempt to restore the pH?

A

compensatory mechanisms

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7
Q

Why can’t we use compensatory mechanisms all the time?

A

it correct pH but not underlying cause

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8
Q

What are the 3 major buffer systems that reduce or raise hydrogen ion concentration?

A

chemical buffer systems, respiratory compensation, renal compensation

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9
Q

What four buffers are chemical?

A

bicarbonate buffers, phosphate and ammonia buffers, hemoglobin and albumin and globulins, and potassium-hydrogen exchange

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10
Q

How do bicarbonate buffers work?

A

bind to or release hydrogen ions depending on whether pH needs to be raised or not

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11
Q

Phosphate and ammonia buffers are a response from the?

A

kidney

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12
Q

What protein is intracellular?

A

hemoglobin

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13
Q

What proteins are extracellular?

A

albumin and globulins

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14
Q

Hemoglobin, albumin, and globulins are protein buffers that?

A

raise or lower pH

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15
Q

What does the potassium- hydrogen exchange do?

A

substitutes reabsorption of potassium with hydrogen in the kidney

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16
Q

When does potassium-hydrogen exchange occur?

A

during acidosis

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17
Q

What 2 actions occur during potassium-hydrogen exchange?

A
  1. H+ and K+ move freely between ICF and ECF
  2. Excess H+ moves into cells in exchange for K+
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18
Q

Where does H+ move during alkalosis?

A

outside of cell

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19
Q

During respiratory compensation, CO2 is retained during?

A

alkalosis

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20
Q

During respiratory compensation, CO2 is blowing off during?

A

acidosis

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21
Q

When the metabolic system isn’t working, what is used?

A

respiratory compensation

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22
Q

What buffer system is the slowest?

A

renal compensation

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23
Q

During renal compensation, retention of bicarbonate is seen during?

A

alkalosis

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24
Q

During renal compensation, excretion of bicarbonate is seen during?

A

acidosis

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25
Q

During renal compensation, elimination of H+ in urine is only possible if…

A

kidneys are healthy

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26
Q

The product of renal compensation?

A

new bicarbonate

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27
Q

What is a normal waste product of cellular metabolism?

A

acid

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28
Q

The pH during acidosis?

A

<7.35

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29
Q

What is another name for carbonic acid?

A

volatile acid

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30
Q

What produces carbonic acid?

A

carbon dioxide and bicarbonate

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31
Q

What is the normal PCO2 level?

A

35-45mmHg

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32
Q

CO2 is dissolved in the?

A

bloodstream

33
Q

Is carbonic acid easily eliminated?

A

yes, by changing respirations. but only if lungs are healthy.

34
Q

What are the 2 ways metabolic acids are eliminated?

A
  1. neutralized by circulating basic compounds
  2. excreted by kidneys
35
Q

What is the normal bicarbonate buffer (HCO3) level?

A

22-26 mEq/L

36
Q

What are the 3 physiologic effects of acidosis?

A
  1. decreases cardiac contractility
  2. interferes with action of drugs
  3. nervous system changes
37
Q

How does acidosis interfere with the actions of drugs?

A

can make ineffective or too effective

38
Q

What are some nervous system changes that can be seen during acidosis?

A

weakness, confusion, coma

39
Q

What is respiratory acidosis?

A

increase in PCO2 and decreased pH

40
Q

The relationship between pH and CO2 is?

A

inverse

41
Q

What are the 2 causes of respiratory acidosis?

A
  1. disorders of ventilation
  2. increased CO2 production
42
Q

What are 4 examples of disorders of ventilation?

A
  1. respiratory part of brain damaged
  2. airway obstruction
  3. chest injuries
  4. drug overdose
43
Q

What 4 things can cause increased CO2 production?

A
  1. sepsis
  2. burns
  3. fevers
  4. exercise
44
Q

What are the 3 manifestations (signs & symptoms) of respiratory acidosis?

A
  1. headaches
  2. impaired consciousness
  3. carbon dioxide poisoning
45
Q

What is metabolic acidosis?

A

deficient in base bicarbonate and decreased pH

46
Q

What is the relationship between pH and HCO3?

A

direct

47
Q

What are the 4 causes of metabolic acidosis?

A
  1. increased production of metabolic acids
  2. decreased renal function
  3. increased bicarbonate loss
  4. hyperchloremic acidosis
48
Q

An increase in production of metabolic acids also means an increase in?

A

lactic acid

49
Q

What occurs during decreased renal function?

A

kidneys cannot excrete hydrogen ions which indicates renal failure

50
Q

How does the body increase bicarbonate loss?

A

by diarrhea and vomiting

51
Q

How can hyperchloremic acidosis occur?

A

by certain drugs, toxins, and IVs

52
Q

What are the 5 manifestations of metabolic acidosis?

A
  1. low BP
  2. abdominal pain
  3. vomiting
  4. headaches
  5. weakness/fatigue
53
Q

What is alkalosis?

A

acid deficit or base excess

54
Q

What is the pH during alkalosis?

A

pH >7.45

55
Q

What is the principal base compound?

A

bicarbonate (HCO3)

56
Q

How is bicarbonate regulated?

A

by kidneys

57
Q

What are the 3 ways bicarbonate are formed?

A
  1. breakdown of carbonic acid
  2. GI intake of ingested bicarbonate
  3. renal absorption of bicarbonate
58
Q

Alkalosis inhibits the release of?

A

O2 from RBCs which can cause hypoxia

59
Q

How does alkalosis effect the cardiac system?

A

influences cardiac rhythm

60
Q

In what 5 ways does alkalosis effect the nervous system?

A
  1. hyperactive reflexes
  2. confusion
  3. seizures
  4. tetany
  5. numbness/tingling
61
Q

What is respiratory alkalosis?

A

decreased PCO2 and increased pH

62
Q

What are the 3 causes of respiratory alkalosis?

A
  1. hyperventilation
  2. mechanical ventilation
  3. central stimulation of respiratory center
63
Q

What occurs during hyperventilation?

A

blow off CO2

64
Q

How can mechanical ventilation cause respiratory alkalosis?

A

someone’s settings on their ventilator are too high

65
Q

What 5 stimuli can cause respiratory alkalosis?

A
  1. anxiety
  2. pain
  3. stress
  4. fever
  5. certain medications
66
Q

What are the 4 manifestations of respiratory alkalosis and metabolic alkalosis?

A
  1. lightheaded
  2. dizzy
  3. constriction of blood vessels
  4. numbness/tingling in fingers and toes
67
Q

What is metabolic alkalosis?

A

increased HCO3 and increased pH

68
Q

What are the 3 causes of metabolic alkalosis?

A
  1. excess alkali intake
  2. bicarbonate retention
  3. gastrointestinal losses
69
Q

How is excess alkali intake achieved?

A

orally or through IVs
(anti-acids and lactated ringers)

70
Q

Bicarbonate retention is seen when there is impaired function of?

A

kidneys

71
Q

How are gastric acids lost?

A

through vomiting or oral/GI suctioning

72
Q

What is combined disturbances?

A

multiple organ systems being involved

73
Q

ABG =

A

arterial blood gas

74
Q

What is the purpose of laboratory blood gas analysis?

A

Reveal information about acid-base balance by evaluating the pH, HCO3- and CO2 levels

75
Q

In what order do you do a systemic interpretation of AC imbalance?

A

pH-> pCO2-> HCO3

76
Q

If pH is low, pCO2 is high, and the HCO3 is normal what is this patient experiencing?

A

respiratory acidosis

77
Q

If pH is high, pCO2 is low, and the HCO3 is normal what is this patient experiencing?

A

respiratory alkalosis

78
Q

If pH is low, pCO2 is normal, and HCO3 is low what is this patient experiencing?

A

metabolic acidosis

79
Q

If pH is high, pCO2 is normal, and HCO3 is high what is this patient experiencing?

A

metabolic alkalosis

Pathophysiology (11 decks)

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