Acid Base Balance

Question 1

What physiological systems maintain fluid, electrolyte and acid-base balance?

Answer 1

Renal and respiratory systems

The kidneys and digestive tracts regulate metabolic functions and maintain homeostasis.

Question 2

What is the normal digestive tract pH?

Answer 2

2.5 - 3

This acidic environment is crucial for digestion.

Question 3

How do kidneys regulate bicarbonate?

Answer 3

By changing bicarbonate generation, excreting, and/or reabsorbing bicarbonate.

Question 4

What role do the lungs play in acid-base balance?

Answer 4

Regulate respiratory functions and alter acid-base balance by changing carbon dioxide concentration.

Question 5

What is the survival pH range for humans?

Answer 5

Less than 6.8 or more than 7.55.

Question 6

What is FiO2?

Answer 6

Fraction of inspired oxygen.

Question 7

What is the normal tidal volume?

Answer 7

400-500 ml.

Question 8

What is the purpose of measuring arterial blood gas (ABG)?

Answer 8

To evaluate the effectiveness of gas exchange.

Question 9

What does pH measure in the blood?

Answer 9

Amount of base or acid.

Question 10

What is the normal range for pH in arterial blood?

Answer 10

7.35 - 7.45.

Question 11

What happens when pH is too acidic?

Answer 11

The lungs REMOVE CO2.

Question 12

What happens when pH is too alkaline?

Answer 12

The lungs CONSERVE CO2.

Question 13

What is acute renal failure?

Answer 13

A sudden and severe decrease in kidney function.

Question 14

What does an eGFR less than 20 ml/min indicate?

Answer 14

The kidneys cannot excrete acids in the bloodstream.

Question 15

What is the anion gap?

Answer 15

The difference between cations and anions in the blood.

Question 16

What are the normal ABG results for bicarbonate (HCO3)?

Answer 16

22-26 mEq/L.

Question 17

What is the compensation mechanism for respiratory acidosis?

Answer 17

Kidneys retain bicarbonate.

Question 18

What is the interpretation step for ABGs concerning pH?

Answer 18

Determine if the pH is low (acidosis) or high (alkalosis).

Question 19

What indicates uncompensated respiratory acidosis?

Answer 19

pH is abnormal and kidneys have not had time to compensate.

Question 20

What are common symptoms of respiratory acidosis?

Answer 20

• Increased HR and RR * Headache * Dizziness * Lethargy * Confusion * Muscle twitching

Question 21

What is metabolic acidosis?

Answer 21

A condition where kidneys cannot eliminate enough acid or retain enough bicarbonate.

Question 22

What are the signs and symptoms of metabolic acidosis?

Answer 22

• Headache * Confusion * Drowsiness * Weakness * Nausea/Vomiting * Kussmaul breathing

Question 23

What causes respiratory alkalosis?

Answer 23

Breathing pattern that results in excessive CO2 loss.

Question 24

What are common symptoms of respiratory alkalosis?

Answer 24

• Confusion * Difficulty focusing * Headache * Tingling * Palpitations * Tremors

Question 25

What is metabolic alkalosis?

Answer 25

Too much bicarbonate in the blood causing pH to rise above 7.45.

Question 26

What causes metabolic alkalosis?

Answer 26

* Excessive acid loss (e.g., NG suctioning, prolonged vomiting) * Excess bicarbonate intake.

Question 27

What is the compensation mechanism for metabolic alkalosis?

Answer 27

Lungs retain CO2 to balance pH.

Question 28

What is the normal pH range of blood?

Answer 28

7.35-7.45

Question 29

What is the pH range that indicates a tendency towards alkalosis?

Answer 29

7.41-7.45

Question 30

What causes metabolic alkalosis?

Answer 30

Excessive acid loss due to NG suctioning, prolonged vomiting, or too much bicarbonate or antacid administration

Question 31

List some signs and symptoms of metabolic alkalosis.

Answer 31

* Dizziness * Tingling of extremities * Hypertonic muscles * Decreased respiratory rate and depth

Question 32

What is the primary intervention for metabolic alkalosis?

Answer 32

Correct the cause

Question 33

What vital signs indicate a patient who may be experiencing metabolic disorder due to vomiting?

Answer 33

145/90 BP, 110 pulse, 30 RR, 88% O2 Saturation on 2L NC

Question 34

What metabolic disorder may a nurse suspect in a patient with prolonged vomiting and lethargy?

Answer 34

Metabolic alkalosis

Question 35

What vital signs indicate a respiratory disorder in an elderly patient with confusion and diminished lung fields?

Answer 35

155/95 BP, 90 pulse, 35 RR, 83% O2 Saturation on 2L NC

Question 36

What respiratory disorder might a nurse suspect in an elderly patient presenting with confusion?

Answer 36

Respiratory acidosis

Question 37

What does a pH of 7.25 indicate?

Answer 37

Acidosis

Question 38

What does a pH of 7.48 indicate?

Answer 38

Alkalosis

Question 39

What is the CO2 level associated with a pH of 7.25?

Answer 39

60

Question 40

What is the HCO3 level associated with a pH of 7.48?

Answer 40

30

Question 41

List nursing diagnoses related to acid-base imbalances.

Answer 41

* Impaired gas exchange * Impaired oxygenation * Impaired tissue perfusion * Ineffective breathing pattern

Question 42

What are some interventions for a patient with an acid-base imbalance?

Answer 42

* Encourage incentive spirometry every hour while awake * Maintain semi to high Fowlers position * Provide smoking cessation education if appropriate * Administer breathing treatments and medications as prescribed * Monitor O2 saturation, breathing effort, respiratory rate, and lung sounds * Monitor ABGs * Monitor fluid and electrolytes

Question 43

What are the expected outcomes of evaluation for a patient with an acid-base imbalance?

Answer 43

* Improvement in incentive spirometry * Improvement in ABGs * Improvement in effort * Improvement in O2 saturation * Comfort measures provided * Signs of improving cause of imbalance

Question 44

What is the treatment for respiratory acidosis?

Answer 44

* Get rid of acid (BiPap, Intubation) * Administer HCO3

Question 45

What is the treatment for metabolic acidosis?

Answer 45

* Get rid of acid * Give fluids * Treat the cause * Administer HCO3 * Administer insulin for DKA

Question 46

How should respiratory alkalosis be treated?

Answer 46

* Provide oxygen * Use a brown bag * Treat the cause of hyperventilation

Question 47

How should metabolic alkalosis be treated?

Answer 47

* Treat the cause * Give fluids