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Surgery > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

What does the PaCO2 determine

A

If respiratory component is present

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2
Q

What does the calculated HCO3 identify

A

Metabolic component

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3
Q

What does PaO2 and PaCO2 provide

A

Information about alveolar gas exchange

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4
Q

What are causes of acid base dysfunction

A

Abnormalities in the respiratory and metabolic system
*any primary disturbance will invoke a compensatory response

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5
Q

What are the components of venous blood gas

A
  1. pH and HCO3
  2. PO2
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6
Q

What are the components of capillary blood gas

A

Easier to obtain and less traumatic than ABG
1. PH
2. PCO2
3. PO2
4. O2 saturation
*>70% acceptable

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7
Q

Where are capillary blood gas sites to obtain

A

Neonates
*heel stick
Adults
*earlobe

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8
Q

When is the pH alkaline or acidic

A

Alkaline
*>7.45
Acidity
*<7.35

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9
Q

What is the respiratory component of acid-base determination

A

PaCO2
*measurement of ventilation
*faster and deeper breathing, CO2 is blown off
*PaCO2 increases, pH decreases
*CO2 is acidic

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10
Q

What is the metabolic component of acid base determination

A

Bicarbonate ion
1. Regulated by the kidney
2. As HCO3 increases pH increases
3. Bicarbonate is alkalotic

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11
Q

What is ABG analysis an indirect measurement of

A

O2 in arterial blood
*PaO2 used to determine effectiveness O2 therapy

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12
Q

What happens to the pH and CO2 when there is a respiratory issue

A

They will move in opposite directions

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13
Q

What happens to the pH and HCO3 if there is a metabolic issue

A

They will move in the same direction
*both high = alkalosis
*both low = acidosis

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14
Q

When will there be a acidosis or alkalosis problem (pH)

A

Acidosis = <7.37
Alkalosis = >7.44

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15
Q

When will there be a acidosis or alkalosis problem (PaCO2)

A

Acidosis > 44mmHg
Alkalosis = <36mmHg

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16
Q

When will there be a acidosis or alkalosis problem (HCO3)

A

Acidosis = <22
Alkalosis = >26

17
Q

If the pH and CO2 are both acidic where is the primary disturbance

A

Respiratory acidosis

18
Q

If the pH and CO2 are both alkalotic where is the primary disturbance

A

Metabolic alkalosis

19
Q

What are common causes of metabolic acidosis

A
  1. Severe diarrhea
  2. DKA
  3. Renal failure
  4. Trauma
  5. Shock
20
Q

What are common causes of metabolic alkalosis

A
  1. Chronic vomiting
  2. Gastric suctioning
  3. Hypovolemia
  4. Diuretics
21
Q

What are common causes of respiratory acidosis

A
  1. Respirator depression / failure
  2. Saddle PE
  3. Aspiration
  4. Pneumonia
22
Q

What are the common causes of respiratory alkalosis

A
  1. Hyperventilation / pain / anxiety
  2. Hypoxemic conditions
  3. Pregnancy
23
Q

What are the common causes of mixed acid / bases disorders

A
  1. Metabolic acidosis superimposed on respiratory alkalosis
    *septic shock + Hepatorenal syndrome
    *salicylate posioning
24
Q

What are some causes of respiratory acidosis (decreased pH with increased pCO2)

A
  1. Hypoventiliation
  2. Impaired alveolar exchange
  3. COPD
25
Q

What are the treatments for respiratory acidosis

A

Improve ventilation
1. Oxygen, BIPAP
2. Narcan
3. Incentive spiromterty
4. Diuretics
5. Mechanical ventilation

26
Q

What is the most useful treatment to blow off excess CO2

A

BIPAP

27
Q

What is vital in determining the cause of metabolic acidosis

A

Anion gap
*normal 8-12

28
Q

What is the anion gap equation

A

NA+ (-) (Cl. + HCO3)

29
Q

What are causes of increased anion gap (MUDPILES)

A

M: methanol
U: uremia
D: DKA
P: paraldehyde
I: Ischemia
L: lactic acidosis
E: ethylene glycol (ETOH)
S: salicylates

30
Q

What is the treatment for when there is an increased anion gap

A
  1. Identify and treat the underlying cause
  2. Replace sodium bicarbonate
31
Q

What is non-anion gap acidosis also caled

A

Hyperchloremic acidosis
*CL- is elevated

32
Q

What are causes of non-anion gap metabolic acidosis

A

D: diarrhea
U: urethral diversion
R: renal tubular acidosis
H: hyperalimentation
A: ammonium chloride / acetazolamide
M: miscellaneous

Surgery (31 decks)

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