Flashcards in ACID BASE BALANCE Deck (23):
what are the major chemicals you have to remember with Acid-base balance?
1. Bicarb (base)
2. Co2 (Acid)
3. Hydrogen (Acid)
What are the major lung and kidney chemicals?
Lung = C02 (Carbonic Acid)
Kidney = Hydrogen & Bicarb
These chemicals can either make you sick or compensate. It depends in which imbalance you have.
What does the pH tell you about the blood?
If it is.....Acidic, alkaline or neutral
What is the normal range for pH?
What does it mean if the pH is below 7.35?
What does it mean if the pH is above 7.45?
Alkalosis=Nervous system excites = convulsions/death
The body is continuously adjusting C02, BiCarb, & Hydrogen to keep the pH between 7.35-7.45.
How does the body stay within normal range by utilizing compensating organs such as, kidneys & Lungs?
-Removes acid thru urine
-Holds on Bicarb returns to blood OR Excrete thru the
-Kidneys take hrs. or days to do their job (slow).
- Rids C02 thru exhale
- Hypoventilation = Retain C02
- Lungs respond FAST
Describe the Pathophysiology of Respiratory Acidosis
Acute or Chronic Lung Problem caused by too much C02 = Hypo-ventilating. Therefore retains C02 (acid) therefore kidneys will compensate with Bicarb and Hydrogen.
In acidosis the body is trying to compensate b/c of less acid so... the body must excrete the acid, which means get rid of hydrogen. Therefore the body will retain bicarb b/c its a Base and pH will be low.
Causes of Respiratory Acidosis
Mid abdominal incision, narcotics, sleeping pills,
pneumothorax, collapsed lung, pneumonia.
* All have poor gas exchange therefore retaining C02 =
Narcotics & Sedatives suppress respirations causing C02 retention.
If C02 is high then O2 low so hypoxia sets in.
S/S Respiratory Acidosis
1. Headache, confused, sleepy
2. If not corrected=COMA
3. Hypoxia-give O2, early signs are restlessness & tachycardia
NOTE: With Restlessness THINK HYPOXIA 1st
As acid concentration C02 increases LOC decreases
Treatment: Respiratory Acidosis
Fix breathing problem first.
- Rid secretions postural drainage
- Percussion (vibe therapy) losens
- Deep breathing exercises
- Suctioning remove secretions
- Fluids liquify secretions
- Elevate HOB - expand lungs better.
- Incentive Spirometry - expand lungs
- Tx. Pneumothorax - Pt. will have chest tube.
- Encourage post op pt. turn, cough, deep breath.
- Prevent pneumonia = prevent respiratory acidosis
Describe the Pathophysiology of Respiratory Alkalosis
Lungs are sick, so kidneys compensate
Kidneys excrete Bicarb, & Retain Hydrogen
Losing C02 (acid)
pH is high - anything over 7.45 = alkalosis
Causes of Respiratory Alkalosis
Hysterical Acute Aspirin Overdose
Situation Hysterical Client
*Pt breathing to fast therefore removing C02 (acid)
S/S Respiratory Alkalosis
Light headed or faint feeling
Numbness & tingling in fingers & toes
Tx. Respiratory Alkalosis
Do not wait for kidneys to kick in.
Breathe into a paper bag
May have to sedate Pt.
Tx. the cause
Describe the Pathophysiology of Metabolic Acidosis
Kidneys are sick-problem chemical hydrogen & Bicarb. Lungs compensate with CO2. pH is low and Respiratory rate is high.
Causes: Metabolic Acidosis
DKA & STARVATION - cells are starving for glucose so body will breakdown protein & fat and produce ketones. ketones are acid.
SEVERE DIARRHEA - losing base from body leaving acid behind = metabolic problem.
S&S: Metabolic Acidosis
Depends on the cause:
HYPERKALEMIA = muscle twitching, muscle weakness, flaccid paralysis and arrhythmia's
INCREASED RESPIRATORY RATE
TX. Metabolic Acidosis
TX. THE PROBLEM
Drug to help acidosis, I.V. push
Sodium Bicarb - wont fix the cause but it will buy you time.
Describe the Pathophysiology of Metabolic Alkalosis
Kidneys are sick, so problem chemical = Bicarb and Hydrogen. Lungs compensate with CO2.
PT in Alkalosis, therefore retaining to much Bicarb (base) & excreting hydrogen.
pH is high- the more alkaline the higher the pH.
S&S: Metabolic Alkalosis
- Depends on cause
- Observe LOC
- Serum Potassium increases in Metabolic Acidosis and
decreases in metabolic Alkalosis.
- Monitor for muscle cramps and life threatening arrhythmia's.
Tx. Metabolic Alkalosis
Fix the problem