Acid Base Flashcards by Giselle Carter

what does a blood gas analyzer measure

pH
PaCO2
PaO2
ABE
K+
Na+
Cl-
HCO3-
proteins

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what is a normal amount of TP in a herbivore/person

65 g/L

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what is a normal range of ABE

-4 to 4 mEq/L

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what is a normal amount of HCO3-

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what equation is the traditional method of acid-base

Henderson-Hasselbach

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what does the traditional method of acid-base estimate (2)

pH and base excess/deficit

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Henderson-hasselbach defines _________ but not _________

magnitude of change; cause

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what is the hydrolysis reaction

H20 + Co2 -> H2Co3 -> HCO3- + H+

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what is the implication of the hydrolysis reaction

high Co2 causes high HCO3 and high HCO3 causes high CO2

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what is H2Co3

Carbonic acid; volatile acid

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what are examples of non-volatile (metabolic) acids

inorganic acid, organic acid, lactic acid, ketoacid

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what is base excess/deficit? what does it reflect?

any difference from the normal range for HCO3 (-4 to 4)

reflects non-volatile (metabolic) acid changes

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how do we calculate base excess/deficit

it is the deviation x 1.2

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what is a buffer

substance that prevents extreme changes in the free concentration of H+ within solution

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name 4 examples of buffers

HCO3
phosphate
protein
NaHCO3

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during transport, what % of CO2 is dissolved? what % is transported as HCO3? what % is HbCO2NH2 (carbaminohemoglobin)

7% dissolves; 80% HCO3; 13% as HbCO2NH2

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when CO2 is being bound to RBC/released from RBC, what balances the negative charge created through the formation of HCO3-

Cl- (either enters or leaves)

what is an ion? what are the 2 types

an ion is a dissociated solute: cations (+) and anions (-)

what does an acid do to solutions? what does a base do

acid donates H+; base removes H+

what are unmeasured anions

anions that are not routinely measured (aka ion gap)

what are examples of anions in the unmeasured anions category

phosphate, ketoacids, sulphate, organic acids, +/- proteins

what are the causes of metabolic acidosis

hyperchloremia
acids from tissue metabolism (lactic acid, unmeasured acids)
combination of the two

how do we determine respiratory vs metabolic acidosis or alkylosis

changes in the ABE reflect METABOLIC; increased pH = alkylosis and increased pH = acidosis

respiratory acidosis = ________; respiratory alkylosis = ____________

increased PaCO2; decreased PaCO2

what formula do you use to determine if there is a respiratory component to metabolic acidosis: for every 10mmHg decrease in CO2, HCO3- decreases 2-3 units CO2 = 0.9 (HCO3-) + 9 CO2 = 1.5 (HCO3-) + 8 for every 10mmHg increase in CO2, HCO3- increases 1.3 units

CO2 = 1.5 (HCO3-) + 8 If value is within this range, there is no respiratory component

What formula do you use to determine if there is a respiratory component to metabolic alkylosis for every 10mmHg decrease in CO2, HCO3- decreases 2-3 units CO2 = 0.9 (HCO3-) + 9 CO2 = 1.5 (HCO3-) + 8 for every 10mmHg increase in CO2, HCO3- increases 1.3 units

CO2=0.9(HCO3-)+9

What formula do you use to determine if there is a metabolic component to respiratory acidosis for every 10mmHg decrease in CO2, HCO3- decreases 2-3 units CO2 = 0.9 (HCO3-) + 9 CO2 = 1.5 (HCO3-) + 8 for every 10mmHg increase in CO2, HCO3- increases 1.3 units

for every 10mmHg increase in CO2, HCO3- increases 1.3 units

What formula do you use to determine if there is a metabolic component to respiratory alkylosis for every 10mmHg decrease in CO2, HCO3- decreases 2-3 units CO2 = 0.9 (HCO3-) + 9 CO2 = 1.5 (HCO3-) + 8 for every 10mmHg increase in CO2, HCO3- increases 1.3 units

for every 10mmHg decrease in CO2, HCO3- decreases 2-3 units

what is another name for the quantitative method

Stewart's method

according to Stewart's method, what determines blood pH (3)

- PaCO2 - SID (strong ion difference) - weak acids (proteins in blood)

how do we determines the SID

(Na+ + K+)-Cl-

what is a normal SID? what is metabolic acidosis? what is metabolic alkylosis

44 ; acidosis < 44; alkylosis > 44

T/F the concentrations of strong ions are not affected by other ions

how do we determine anion gap (AG)

= SID + HCO3 = (Na + K) - (Cl + HCO3)

what is a normal value for AG? what is metabolic acidosis? metabolic alkylosis?

20; acidosis > 20; alkylosis < 20

is SID or AG more reliable? why?

SID; AG includes HCO3- making it unreliable

what can make anion gap more reliable

proteins

proteins act as weak ______; thus, hypoproteinemia = ____________ and hyperproteinemia = _______________

acids; metabolic alkylosis; metabolic acidosis

how do we determine SIG

SIG = AG - (total proteins x 0.25) = (SID + HCO3) - (total proteins x 0.25)

what does SIG allow us to determine

the unmeasured anions (lactate)