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Flashcards in Acid-Base Balance Deck (35)
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1

What does pH tell you about the blood?

• If the blood is acidic, alkaline, or neutral.

2

Major chemicals you have to remember



1.)C02

2.)HCO3

3.)Hydrogen





2

What chemical is produced by the lungs ?

What chemicals are produce by the kidneys ?

What do this chemicals do ?

What does HCO3=




1.). Lung chemicals → CO (acid)

2..). Kidney chemicals → bicarb and hydrogen

These chemicals can either make you sick or compensate. It depends on which
imbalance you have.

Bicarb (base )=HCO3) , Hydrogen( acid ), CO2(acid)-it mixes with water in the body and becomes carbonic acid

3

Normal pH range _________-_______



every solution has a pH
Water=
A coke =

7.35-7.45

every solution has a pH
Water=7
A coke =3

4

What does pH below 7.35 means the PH is ?

So a pt can go into ?



Acidosis

Very serious problems
A person can going to coma and die

5

What does pH above 7.45 means the PH is ?

So a pt can go into ?

Alkalosis

makes the nervous system becomes very excited which can lead to convulsions and die

6

5. The _________ does not like it when the pH is messed up.

The brain

7

How’s does The kidneys removed hydrogen ?

How’s does The kidneys removed the bicarb ?


How long does the kidney take to work ?

Urine = excrete exess hydrogen ion Through the urine and retain those ions if the body needs more acids

The kidneys either hold on to bicarb and return it back to the blood or they excreted thru the urine

Kidneys takes hours to days to do
their job-they are slow but efficient

8

How does the lungs retain CO2 ?

How does the lungs get rid CO2 ?

How long does it take to work ?

Exhale so increasing or decreasing the respiratory rate will alter the amount of CO2 in the body

Hypoventilation retain CO2
__________ Hyperventilation eliminate CO2

The lungs response is fast-they take seconds to minutes but they are not as efficient is the kidneys

9

What are the 6 causes of respiratory acidosis

Men never see pink purple Canarys

Causes:

• Retain CO2

Mid abdominal incision,

narcotics,

sleeping pills,

pneumothorax,


pneumonia


collapsed lung,

10

Respiratory Acidosis:


1. Pathophysiology:

Is this a lung problem or a kidney problem? Lungs

b. What chemical is causing the problem? CO2-this is the only chemical

c. Do we have too much or too little of this chemical in the body? Too much CO2

d. Hypoventilating or hyperventilating? Hypoventilating AND BREATHING way too slow causing them to retain CO2

e. Who’s going to compensate? Kidney

f. How, with what chemicals? Bicarb and hydrogen

g. The body must excrete the acid. --other words get rid of the hydrogen

h. The body will retain bicarb. --so the body Secrete bicarb into the blood because A base in a Acid solution that solution is going to become less acid. The whole purpose of compensation is to return to balance state

i. Is the pH high or low? Low

11

11S/S respiratory acidosis

Hypoxic
• Give them ___________________
• Early sign and symptoms of hypoxia? _______________ & ______________

S/S:

a. Headache, confuse, sleepy

1•Bradycardia
2• Bradypnea
3•hypo-reflexia,
4• Hypotension
5;•anorexia
6• ↓ lucidity
7• lethargy
8• coma
9• cardia arrest
10• suppressed, decreased, falling
11•paralytic ileus (decreased
bowel sounds)


b. If not corrected, could lead to a coma
c. Hypoxic because one CO2 is a high oxygen is low making it harder to breathe

• Give them oxygen

• Early sign and symptoms of hypoxia? Restlessness and tachycardia

12

*TESTING STRATEGY*
Restlessness think what 1st?

Hypoxia

13

Treatment for respiratory acidosis

Tx:

a. Fix the breathing problem. Because the client would not improve into the breathing problem is fixed

b. 7 Treat pneumonia, get rid of secretions by postural drainage, percussion (vibration
therapy), deep breathing exercises, suctioning, fluids, elevate HOB, and incentive
spirometry.

c. Pneumothorax client will have chest tubes

d. Encourage post-op to turn, cough and deep breath

If you help prevent pneumonia you help prevent respiratory acidosis as well

14

Respiratory alkalosis pathophysiology

Who’s sick? Lungs Who’s going to compensate? Kidneys
b. Kidneys excrete bicarb Retain hydrogen
c. Problem chemical? CO2
d. Gaining or losing CO2
?
Losing

e. Hypoventilating or hyperventilating? Hyperventilate
f. pH? High

15

*TESTING STRATEGY*
↑CO2
*TESTING STRATEGY*
↑CO2= ↓LOC
↑CO2= ↓O2
CO2and O2have an inverse
relationship.

= ↓LOC
↑CO2

= ↓O2

CO2

and O2

have an inverse
relationship.

*TESTING STRATEGY*
↑CO2= ↓LOC
↑CO2= ↓O2
CO2and O2have an inverse
relationship.

16

Normal lab values for PH are?

Normal Lab Values
pH: ?
PaO2 : ?mmHg
PaCO2: ? mmHg
HCO3: Bicarbonate: ? mEq/L

Normal Lab Values
pH: 7.35-7.45
PaO2 :80-100 mmHg
PaCO2: 35-45 mmHg
HCO3: Bicarbonate: 22-26 mEq/L

17

Causes respiratory alkalosis

Causes:

a. Problem? Hyperventilation

b. Hysterical
The client is breathing too fast and,
c. Acute aspirin overdose therefore, removing CO2

d. Situation: Hysterical client

18

10 Signs and symptoms of respiratory alkalosis

S/S:

• Lightheaded, faint, peri-oral numbness, numbness and tingling in fingers and toes.


•Tachycardia
• Tachypnea
•Hyperreflexia
• Hypertensive
•tetany
•Tremors
• Seizure
• Agitated
•Borborygmi

19

Treatment for respiratory alkalosis

Tx:

a. Do not wait for kidneys to kick in.

b. Breathe into a bag-forces clients to take back their CO2 c. Some people become so anxious they May have to be sedate to decrease respiratory rate.

d. Treat the cause -determine why the client is breathing fast

e. Monitor ABGs

20

Metabolic acidosis pathophysiology

Pathophysiology:


a. Who’s sick? Kidneys
Who’s going to compensate? Lungs

b. With what chemical? CO2
c. Problem chemicals? Bicarb & hydrogen
This client is retaining hydrogen or (excreting )does not have enough bicarb.

d. pH? Low

e. Respiratory rate will increase to get rid of all that acid

21

Causes of metabolic acidosis

Causes:

a. DKA

b. Starvation
Cells are starving for Glucose__, so the body will break down protein and fat produce ketones. ketones are acids. So the acids will go up in the blood
c. Renal failure when the kidneys are failing they are no longer effective in filtering out acid or retaining base

d. Severe diarrhea-The Lower Gi contains alot of bicarb which is a base. So if a client is having diarrhea they are losing base from their body. If exes base is loss then acid remains behind

22

S/S of. Metabolic acidosis

when pH goes up; potassium goes down... when pH goes down; potassium goes up!

S/S:

a. Depend on the causes
b. Hyperkalemia
• Muscle twitching, muscle weakness, flaccid paralysis, arrhythmias
c. Increased respiratory rate

23

Treatment for metabolic acidosis

Tx:

a. Treat the problem
b. Drug to help acidosis? IVP sodium bicarb! It will not fix the problem but it will buy you some time into they figure out what is causing the metabolic acidosis

24

Metabolic alkalosis pathophysiology

Pathophysiology:


a. Who’s sick? Kindneys__
Who’s going to compensate? Lungs

b. With what chemical? _CO2
c. Problem chemicals? Bicarb &hydrogen

The client is in alkalosis, so they are retaining too much bicarb and excreting hydrogen.

e. pH? High

25

Causes of Metabolic alkalosis

Causes:

a. Loss of upper GI contents (vomiting, G.I. secretions that are lost through a G.I. tube through suctioning
b. Too many antacids…. Too much base

c. Too much IV bicarb

26

Signs and symptoms of metabolic alkalosis

S/S:

a. Depend on cause

b. Observe LOC

c. Serum K+ will go up in metabolic acidosis and go down in
metabolic alkalosis.

d. Monitor for muscle cramps and life-threatening arrhythmias

27

Metabolic alkalosis treatment

Tx:
a. Fix the problem.

b. Replace potassium

28

*TESTING STRATEGY*
Metabolic Acidosis = Hyperkalemia

Metabolic Alkalosis = Hypokalemia

*TESTING STRATEGY*
Metabolic Acidosis = Hyperkalemia

Metabolic Alkalosis = Hypokalemia

29

Normal:
pH: acidosis ↓ 7.35 – 7.45 ↑ alkalosis


PCO2: base ↓ 35 – 45 ↑ acidic

HCO3: acidic ↓ 22 – 26 ↑ basic

Normal:
pH: acidosis ↓ 7.35 – 7.45 ↑ alkalosis
PCO2
:
basic ↓ 35 – 45 ↑ acidic
HCO3
:
acidic ↓ 22 – 26 ↑ basic