Acid-Base Balance

Question 1

What are the major chemicals?

Answer 1

Bicarb
H
CO2

Question 2

What is the lung chemical; acid or base?

Answer 2

CO2, acid

Question 3

What are the kidney chemicals; acid or base?

Answer 3

HCO3- Base

H- Acid

Question 4

Compensating organs: Kidneys

Remove acid how?

Answer 4

Through urine

Question 5

Compensating organs: Kidneys

What do they do with bicarb?

Answer 5

Hold on and return it to blood OR excrete through urine

Bicarb is a base–so it is held on when things are too acidic

Bicarb is a base–so it is let go of (excreted through urine) when things are too basic

Question 6

Compensating organs: Lungs

What is one way to get rid of CO2?

Answer 6

Exhale

Question 7

Compensating organs: Lungs

When you HYPOventilate are you retaining or eliminating CO2?

Answer 7

Retain Co2

Question 8

Compensating organs: Lungs

When you HYPERventilate are you retaining or eliminating CO2?

Answer 8

Eliminating CO2

Question 9

Compensating organs

What organ takes hours to days to compensate?
What organs take seconds to minutes?

Answer 9

Hours to days: Kidneys (efficient)

Seconds to minutes: Lungs (not as efficient)

Question 10

Respiratory acidosis

What problem and what chemical causing problem?

Answer 10

Lung problem so CO2 causing it

Question 11

Respiratory acidosis

Too much or too little CO2?

Answer 11

Too much

Question 12

Respiratory acidosis

Hypo or hyperventilating?

Answer 12

HYPOventilating (person retaining CO2 so having too much of it)

Question 13

Respiratory acidosis

Who compensates?

Answer 13

Kidneys with Bicarb and H

Question 14

Respiratory acidosis

What does body do with H to compensate?
What does body do with Bicarb to compensate?

Answer 14

Too much CO2 (acid) so need to EXCRETE acid (H) and retain the Bicarb (base)

Question 15

Respiratory acidosis

What is pH?

Answer 15

Low (acidosis)

Question 16

Respiratory acidosis

Causes?

Answer 16

Anything that makes you retain CO2

• Incisions, narcotics, sleeping pills
• Pneumothorax, collapsed lung, pneumonia

*note: all these cause hypoventilation and/or impaired gas exchange

Question 17

Respiratory acidosis

S/s?

Answer 17

• HA, confused, sleepy
• Can lead to coma
• Hypoxic

Question 18

Respiratory acidosis

What are early s/s of HYPOXIA?

Answer 18

Restlessness and tachycardia

Question 19

Respiratory acidosis

Restlessness think what first?

Answer 19

HYPOXIA!!!

Question 20

Respiratory acidosis

If they are hypoxic, give them ___

Answer 20

O2

Question 21

Respiratory acidosis

Tx?

Answer 21

Fix resp. problem

Tx pneumonia, get rid of secretions, do deep breathing, suction, give fluids, elevate HOB, incentive spirometry

Question 22

Respiratory acidosis

T/F: Pneumothorax client will have chest tube

Answer 22

T

Question 23

Respiratory acidosis

Encourage post-op clients to do what to help prevent resp. acidosis?

Answer 23

To turn, cough, and deep breathe!!

Question 24

Respiratory alkalosis

What organ is sick? What organ compensates?

Answer 24

Sick: Lung
Compensate: Kidneys

Question 25

Respiratory alkalosis What do kidneys excrete to compensate? What do they retain to compensate?

Answer 25

Excrete bicarb | Retain H

Question 26

Respiratory alkalosis Problem chemical?

Answer 26

CO2

Question 27

Respiratory alkalosis Gaining or losing CO2?

Answer 27

Losing!

Question 28

Respiratory alkalosis Hypo or hyperventilating?

Answer 28

Hyperventilating (this is why all acid (CO2) is leaving)

Question 29

Respiratory alkalosis pH?

Answer 29

High

Question 30

Respiratory alkalosis Causes?

Answer 30

- Hyperventilating - Hysterical - Acute aspirin overdose *all these situations client is breathing too fast and removing the Co2

Question 31

Respiratory alkalosis S/s?

Answer 31

Lightheaded or faint feeling Peri-oral numbness Numbness and tingling in fingers/toes

Question 32

Respiratory alkalosis Tx?

Answer 32

- DO NOT wait for kidneys to compensate!! - Breathe into paper bag - Sedate client to decrease RR - Treat cause - Monitor ABG

Question 33

Metabolic acidosis What organ is sick?

Answer 33

Kidney

Question 34

Metabolic acidosis What organ compensates?

Answer 34

Lung, compensates with CO2

Question 35

Metabolic acidosis Problem chemicals?

Answer 35

Bicarb and H+ *the client is either retaining H+ making it too acidic or does not having enough bicarb (not having enough base to balance out)

Question 36

Metabolic acidosis pH?

Answer 36

Low

Question 37

Metabolic acidosis What happens with RR?

Answer 37

Increase (to get rid of acids)

Question 38

Metabolic acidosis What kind of respirations?

Answer 38

Kussmaul respirations

Question 39

Metabolic acidosis Causes?

Answer 39

1. DKA and starvation ---cells starve for glucose so body breaks down protein and fat, which produces ketones. Ketones are acids 2. Renal failure 3. Severe diarrhea (excreting too much base!)

Question 40

Vomit acid or base?

Answer 40

Acids

Question 41

Poop acid or base?

Answer 41

Base

Question 42

Metabolic acidosis S/s?

Answer 42

Depend on cause HYPERkalemia Increased RR

Question 43

Metabolic acidosis What are s/s of hyperkalemia?

Answer 43

Muscle twitching--> arrhythmias Muscle weakness Flaccid paralysis

Question 44

Metabolic acidosis Tx?

Answer 44

Treat problem | Give IV sodium bicarb (base) to help fix (temporary)

Question 45

Metabolic acidosis What is normal bicarb level?

Answer 45

22-26

Question 46

Metabolic alkalosis What organ is sick?

Answer 46

Kidney

Question 47

Metabolic alkalosis What organ is trying to compensate?

Answer 47

Lung with Co2

Question 48

Metabolic alkalosis Problem chemicals?

Answer 48

Bicarb and H

Question 49

Metabolic alkalosis The client is in alkalosis, so they are retaining too much ____ and excreting H

Answer 49

Bicarb

Question 50

Metabolic alkalosis What do upper GI contents have--acids or bases?

Answer 50

Acids

Question 51

Metabolic alkalosis What do antacids have--acids or bases?

Answer 51

Base

Question 52

Metabolic alkalosis What are some causes?

Answer 52

- Loss of upper GI contents (acids) - Too many antacids (base) - Too much IV bicarb (base)--like when you push a lot of bicarb with a code

Question 53

Metabolic alkalosis S/s

Answer 53

- Depend on cause | - Watch LOC

Question 54

Metabolic alkalosis What happens to serum K?

Answer 54

Decreases

Question 55

Metabolic ACIDOSIS What happens to serum K?

Answer 55

Increases

Question 56

Metabolic alkalosis Patient is hypo or hyperkalemic? What happens?

Answer 56

HYPOkalemic Muscle cramps--life threatening arrhythemias

Question 57

Metabolic ACIDOSIS Patient is hypo or hyperkalemic? What happens?

Answer 57

HYPERkalemic Muscle twitching (leads to arrhythmias), muscle weakness, flaccid paralysis

Question 58

Metabolic alkalosis Tx?

Answer 58

Fix problem | Replace K+

Question 59

Metabolic acidosis= ?

Answer 59

Hyperkalemia

Question 60

Metabolic alkalosis= ?

Answer 60

Hypokalemia