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FOUNDATIONS 310 > Acid/Base > Flashcards

Acid/Base Flashcards

1
Q

Functions of acid base balance?

A

homeostasis of body fluids, kidneys, and lungs

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2
Q

what controls Co2?

A

Respiratory process

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3
Q

what controls bicarbonate?

A

kidneys (metabolic process)

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4
Q

Carbons dioxide mixes with water to formwhat?

A

carbonic acid?

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5
Q

bicarbonate and hydrogen ions mix to form what?

A

carbonic acid

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6
Q

2 ways to make carbonic acid

A

co2+ h2o

Hco3 + hydrogen ions

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7
Q

what do you need to make carbonic acid in both processes?

A

carbonic anhydrase

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8
Q

what controls breathing?

A

Co2

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9
Q

how quickly does respiratory system respond to acid base changes?

A

quickly- within minutes

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10
Q

is bicarb an acid or a base?

A

base

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11
Q

is Co2 an acid or a base?

A

acid

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12
Q

the kindeys control acid-base balance through the retention or excretion of what 2 substances?

A

hydrogen ions and bicarbonate ions

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13
Q

how quickly does the renal systems respond to acid base changes?

A

hours to days

-slower than resp but stronger response

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14
Q

how do we figure out acid base status?

A

ABG -arterial blood gas

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15
Q

most common artery for ABG

A

radial or femoral

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16
Q

pH range

A

7.35-7.45

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17
Q

PaCo2 ranges

A

35-45 mmHg

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18
Q

HCO3 ranges

A

22-26 mEq/L

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19
Q

Co2 < then 35 =

A

base

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20
Q

Co2 > 45 =

A

acid

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21
Q

HCO3 <22=

A

acid

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22
Q

HCO3 >26=

A

base

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23
Q

If pH is below 7.35 body will compensate to what range?

24
Q

if pH is above 7.45 body will adjust to

25
when does an UNcompensated acid-base disorder occur?
CO2 or HCO3 = abnormal | pH = normal
26
when does a PARTIALLY compensated acid-base disorder occur
CO2, HCO3, pH are abnormal
27
compensated acid-base disorder occurs when
CO2 + HCO3= abnormal | pH = normal
28
4 types of uncompensated acid-base disorders
metabolic acidosis/alkalosis | respiratory acidosis/alkalosis
29
causes of metabolic acidosis
-excess carbonic acid productions or bicarb deficit: DKA, lactic acid accumulation with anaerobic exercise, renal disease, severe diarrhea
30
how does severe diarrhea cause metabolic acidosis ?
- dehydration lead to build up of lactic acid or shock | - stool contains bicarb and severe diarrhea means prolonged loss of bicarb
31
how does kidney disease cause metabolic acidosis?
kidneys make bicarb so not making enough bicarb
32
metabolic acidosis compensation
- kidneys make more bicarb | - respiratory hyperventilation to blow off CO2
33
what is problem with hyperventilation to treat metabolic acidosis?
- resp compensation is relatively weak | - underlying problem is not addressed
34
s/s metabolic acidosis
- kassmaul's respiration - lethargy, fatigue, coma - hypertension, dysrhythmias - hyperkalemia
35
what are kussmaul's respirations?
deep rapid resps with metabolic acidosis
36
why have hyperkalemia with metabolic acidosis?
H and K have same 1+ charge so they swap places in the cell potassium --> out into intravascular hydrogen --> in to intracellular --see increase in serum potassium
37
metabolic acidosis treatment
kidney impairment --> hemodialysis DKA --> insulin shock --> fluid replacement/shock treatment
38
what can be done to treat hyperkalemia?
insulin + dextrose, loop diuretics
39
metabolic alkalosis causes
- base bicarb excess - prolonged vomiting / gastric suction (loss of hydrochloric acid) - bicarb gain
40
who would be taking bicarbonate supplements and thus be at risk for metabolic alkalosis?
patients with renal insufficiency
41
metabolic alkalosis compensation
- renal excretion of bicarb | - decrease resp rate (occurs first)
42
Metabolic alkalosis s/s
- hyperactive reflexes - paresthiesia - tetany - seizures - resp. depression - hypocalcemia, hypokalemia
43
metabolic alkalosis treatment
- for vomiting/gastric suctioning --> adequate hydration, arginine hydrochloride (raises chloride level) - diuretic: diamox
44
how does arginine hydrochloride treat metabolic alkalosis?
raises chloride levels which are reduced from gastric loss
45
what is diamox? how does it help metabolic alkalosis treatment?
carbonic anhydrase inhibitor - carbonic anhydrase turns bicarb to turn into carbonic acid - if inhibited --> bicarb no go carbonic acid --> excreted instead
46
hypoventilation is < ____ resps/minute
12
47
causes of respiratory acidosis
- hypoventilation - resp failire - injury to medulla - overdose of benzo/opioids (anything with sedative effect)
48
how does medulla injury cause respiratory acidosis?
- medulla is CNS control of respirations | - if no fxn then result in hypoventilation
49
respiratory acidosis compensation
- will only have metabolic renal compensations | - -> kidneys retain bicarb ions or excrete H ions
50
respiratory acidosis s/s
mental status change may occur 1st - ->irritability, disorientation, lethargy, coma, headache - tachycardia
51
why have tachycardia with respiratory acidosis?
trying to get more O2
52
respiratory acidosis treatment
- -priority it treat underlying cause - --obstructive condition --> Bipap or mechanical ventilation - --sedative overdose --> narcan (naloxone) - O2, HOB elevated, antibiotics in pneumonia
53
respiratory alkalosis causes
-acid deficit caused by hyperventilation or pulmonary disorders rapid breathing: anxiety, fever, pain, traums, anemia, asthma, PE, CVA
54
respiratory alkalosis compensation
bicarb shifts INTO cells in exchange for CHLORIDE ions | -if alkalosis persists --> renal excretion of bicarb
55
resp alkalosis s/s
neuromuscular: paraesthesia, dizziness, vertigo, tetany CV: tachy, dysrhythmias, sweating
56
Resp Alkalosis treatment
- pain/anxiety --> intervention for that - asthma --> bronchodilator - anemia --> packed red blood cells, restore Hgb
57
how is bicarbonate made?
carbonic acid dissociates in the kidneys to make a hydrogen ion and bicarbonate

FOUNDATIONS 310 (28 decks)

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