Flashcards in Acid Base Deck (19):
Chemicals affecting pH
1. Bicarb, Hydrogen, CO2
2. Lung chemicals → CO2 →acid
3. Kidney chemicals → bicarbonate and hydrogen
Bbb bicarbonate is a base
H and CO2 are acids.
Kidneys affect pH
Remove acid through urine. Bicarb either holds onto it or secretes it thru the urine
Kidneys takes hours to days to do their job, but they are efficient
How lungs Affect pH
One way to get rid of CO2
What is it? Exhale
Hypoventilation retain CO2
Hyperventilation eliminate CO2
Lungs respond fast, in seconds to minutes, but not as efficient
Respiratory acidosis patho
a. Is this a lung problem or a kidney problem? Lungs
b. What chemical is causing the problem? CO2
c. Do we have too much or too little of this chemical in the body? Too much
d. Hypoventilating or hyperventilating? Hypo
e. Who’s going to compensate? Kidneys
f. How, with what chemicals? Bicarbonate and hydrogen
g. The body must excrete the acid.
h. The body will retain bicarb.
i. Is the pH high or low? Low
Respiratory acidosis causes
Mid abdominal incision, narcotics, sleeping pills, pneumothorax, collapsed lung,
Retain CO2/impaired gas exchange
Respiratory acidosis s/s
Headache, confused, sleepy
If not corrected, could lead to a coma
• Give them oxygen
• Early sign and symptoms of hypoxia? Restlessness & tachycardia
^co2= decreased LOC and O2
Respiratory acidosis treatment
Fix the breathing problem.
Treat pneumonia, get rid of secretions by postural drainage, percussion (vibration therapy), deep breathing exercises, suctioning, fluids, elevate HOB, and incentive spirometry.
Pneumothorax client will have chest tubes
Encourage post-op to turn, cough and deep breath.
a. Who’s sick? Lungs. Who’s going to compensate? Kidneys
b. Kidneys excrete bicarb. Retain hydrogen.
c. Problem chemical is CO2
d. Gaining or losing CO2? Losing.
f. pH? High
Respiratory alkalosis causes
a. Problem? Hyperventilation
c. Acute aspirin overdose
d. Situation: Hysterical client
Breathing too fast and removing CO2
Respiratory alkalosis s/s
Lightheaded, faint, peri-oral numbness, numbness and tingling in fingers and toes
Respiratory Alkalosis treatment
a. Do not wait for kidneys to kick in.
b. Breathe into a bag.
c. May sedate client to decrease respiratory rate.
d. Treat the cause, determine why
a. Who’s sick? kidneys Who’s going to compensate? Lungs
b. With what chemical? CO2
c. Problemchemicals?Hydrogen & Bicarb
This client is retaining hydrogen or does not have enough bicarb.
d. pH? Low
e. Respiratory rate will increase in rate and depth/kussmauls
Metabolic acidosis causes
DKA, Starvation, renal failure, severe diarrhea (bicarb is in the lower GI)
Cells are starving for glucose so the body breaks down fat and produces ketones which are an acid.
Metabolic acidosis s/s
a. Depend on the cause.
• Muscle twitching, muscle weakness,
flaccid paralysis, arrythmias.
c. Increased respiratory rate to blow off CO2
Metabolic acidosis treatment
a. Treat the cause.
Drug to help acidosis? sodium bicarb
IVP-helps while the problem is fixed.
a. Who’s sick? kidneys. Who’s going to compensate? Lungs
b. With what chemical? CO2
c. Problem chemicals? bicarb & hydrogen
d. The client is in alkalosis, so they are retaining too much bicarb and excreting hydrogen.
e. pH? High
Metabolic alkalosis causes
a. Loss of upper GI contents
b. Too many antacids.... Too much base.
c. Too much IV bicarb
Metabolic alkalosis s/s
a. Depend on cause
b. Observe LOC
c. Serum K+ will down in metabolic alkalosis.
d. Monitor for arrythmias and muscle cramps.