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NUR 520 > Acid-base Balance and Arterial Blood gases (Complete) > Flashcards

Acid-base Balance and Arterial Blood gases (Complete) Flashcards

(53 cards)

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1
Q

Blood pH levels

A

Blood is slightly alkaline at pH 7.35 to 7.45
 Less than 7.35 is acidosis
 Greater than 7.45 is alkalosis

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2
Q

Three mechanisms to regulate acid-base balance and
keep pH between 7.35 and 7.45

A

 Buffer system
 Respiratory system
 Renal system

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3
Q

Buffer System

A

-Primary regulator of acid-base balance
- Act chemically to change strong acids to weak acids or bind acids to neutralize them
- Respiratory and renal systems need to be functioning adequately

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4
Q

Carbonic Acid (H2CO3)/
Bicarbonate (HCO3–) Buffer

A

HCl + NaH2CO3 —-> NaCl + H2CO3
- Strong acid + strong base is buffered into salt and weak acid
- Major buffer system

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5
Q

Other Buffer Systems

A

-Phosphate (intercellular)
- Protein
- Hemoglobin (Binds H+ produced by carbonic acid and RBC)
- Cellular
* Shifts H+ in and out of cell in exchange for potassium

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6
Q

Respiratory System Regulation

A

CO2 + H2O —-> H2CO3 —> H++ HCO3−
- Respiratory center in medulla controls breathing
- Increased respirations lead to increased CO2 elimination and decreased CO2 in
blood (Hyper)
- Decreased respirations lead to CO2 retention (Hypo)

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7
Q

Renal System Regulation

A

-Conserves bicarbonate and excretes some acid
- Three mechanisms for acid excretion
 Secrete free hydrogen
 Combine H+ with ammonia (NH3)
 Excrete weak acids

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8
Q

Arterial blood gas (ABG) values give objective information about

A

Acid-base status
Underlying cause of imbalance
Body’s ability to regulate pH
Overall oxygenation status

ARTERIAL BLOOD WILL PULSATE

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9
Q

What is the primary goal of maintaining acid-base balance?

A

To achieve homeostasis

Imbalances can lead to health problems such as diabetes, COPD, and kidney disease.

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10
Q

What does pH measure?

A

H+ ion concentration

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11
Q

What is the normal pH range for blood?

A

7.35 to 7.45

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12
Q

What is acidosis?

A

pH less than 7.35

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13
Q

What is alkalosis?

A

pH greater than 7.45

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14
Q

What are the three mechanisms to regulate acid-base balance?

A
  • Buffer system
  • Respiratory system
  • Renal system
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15
Q

What is the primary function of the buffer system?

A

To regulate acid-base balance by changing strong acids to weak acids or binding acids to neutralize them.

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16
Q

What is the major buffer system in the body?

A

Carbonic Acid (H2CO3)/Bicarbonate (HCO3–) Buffer

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17
Q

What is the role of the respiratory system in acid-base regulation?

A

Controls breathing to regulate CO2 levels.

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18
Q

What happens during hypoventilation?

A

CO2 retention occurs, leading to respiratory acidosis.

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19
Q

What are the three mechanisms for acid excretion in the renal system?

A
  • Secrete free hydrogen
  • Combine H+ with ammonia (NH3)
  • Excrete weak acids
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20
Q

In alkalosis, what happens to potassium levels?

A

Potassium is shifted into extracellular fluid.

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21
Q

What classifications exist for acid-base imbalances?

A
  • Respiratory (CO2)/Metabolic (HCO3)
  • Acidosis/Alkalosis
  • Acute/Chronic
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22
Q

What can arterial blood gas (ABG) values indicate?

Study These Flashcards
A
  • Acid-base status
  • Underlying cause of imbalance
  • Body’s ability to regulate pH
  • Overall oxygenation status
23
Q

Steps to Intererate ABGS

Study These Flashcards
A

Look at each of the values
Look at pH first
Use ROME to determine respiratory or metabolic
Assess the PaO2 and O2 saturation.

24
Q

Normal Blood Gas Values

Study These Flashcards
A

pH: 7.35-7.45
Partial pressure of oxygen (PaO2): 75-100 mmHg
Partial pressure of carbon dioxide (PaCO2): 35-45 mmHg
Bicarbonate (HCO3-): 22-26 mEq/L

25
What is the first step in interpreting ABGs?
Look at pH.
26
What does ROME stand for in ABG interpretation?
Respiratory Opposite, Metabolic Equal
27
What is respiratory acidosis caused by?
* Carbonic Acid in Excess caused by.. * Hypoventilation * Respiratory failure
28
What is respiratory alkalosis caused by?
* Carbonic Acid Decific caused by... * * Hypoxemia from acute pulmonary disorders * Hyperventilation
29
What compensatory mechanism occurs in respiratory alkalosis? | Compensation?
-Can buffer with bicarbonate shift; -renal compensation if chronic. -Rarely occurs when chronic
30
Metabolic Acidosis is ...
Excess carbonic acid or base bicarbonate deficit caused by -Ketoacidosis -Lactic acid accumulation (shock) -Severe diarrhea -Kidney disease
31
What type of acid-base imbalance is ketoacidosis associated with?
Metabolic acidosis
32
What are Kussmaul respirations?
Deep and rapid breathing associated with metabolic acidosis. | compensatory mechanism
33
What causes metabolic alkalosis?
Base Bicarb excess caused by... * * Prolonged vomiting or gastric suction * Gain of HCO3–
34
What compensatory mechanism occurs in metabolic alkalosis? | Compensation?
* Renal excretion of HCO3– * Decreased respiratory rate to increase plasma CO2 (limited)
35
Oral Fluid and Electrolyte Replacement are used to correct..
Mild fluid and electrolyte deficits -Water -Glucose -K+ -Na+
36
What are the purposes of IV fluid and electrolyte replacement?
* Maintenance * When oral intake is not adequate * Replacement * When losses have occured
37
What fluids are hypotonic?
Fluids that have Lower osmolality compared to plasma (Dilutes the ECF)
38
What happens to water in hypotonic IV fluids?
Moves from ECF to ICF by osmosis.
39
What are the two main purposes of IV fluid and electrolyte replacement?
Maintenance and Replacement ## Footnote Maintenance is used when oral intake is not adequate, while Replacement is for when losses have occurred.
40
What characterizes hypotonic IV fluids?
Lower osmolality compared to plasma ## Footnote Hypotonic fluids dilute ECF and cause water to move from ECF to ICF by osmosis.
41
What is D5W and its primary use?
Technically isotonic; used to replace water losses | (Good for diarrhea patient) ## Footnote Dextrose quickly metabolizes, resulting in free water and providing 170 cal/L.
42
What is D5W good for and waht does it do?
Used to replace water losses, helps prevent ketosis (also good for diarrhea patients)
43
What defines isotonic IV fluids?
Similar osmolality to ECF | No net loss or gain ## Footnote Isotonic fluids expand only ECF and are ideal to replace ECF volume deficit.
44
What is Normal Saline (NS) and when is it used?
Isotonic; used when both fluid and sodium are lost | 0.9% ## Footnote NS is the only solution that can be used with blood transfusion
45
What does Lactated Ringer’s Solution contain?
Sodium, potassium, chloride, calcium, and lactate ## Footnote It is isotonic and expands ECF, useful for treating burns and GI losses.
46
When are lactated ringers contraindicated?
For patients with liver dysfunction, hyperkalemia, and severe hypovolemia
47
What characterizes hypertonic IV fluids?
Higher osmolality compared to plasma ## Footnote Hypertonic fluids draw water out of cells into ECF and require frequent monitoring.
48
Hypertonic IV fluids require frequent monitoring of?
-BP -Lung sounds (crackles..lungs will start to retain fluid) -Serum sodium levels
49
What is D5 ½ NS used for?
Common maintenance fluid; replaces fluid loss -Is hypertonic | Monitor ABC's and Lung sounds ## Footnote KCl may be added for maintenance or replacement.
50
What is D10W and its significance?
Hypertonic; provides 340 kcal/L ## Footnote D10W provides free water but no electrolytes and is the limit of dextrose concentration that may be infused peripherally.
51
What are colloids and their function?
Stay in vascular space and increase oncotic pressure ## Footnote Colloids include human plasma products like albumin and semisynthetics like dextran and starches (hespan).
52
What imbalance is this? pH 7.18 PaCO2 38 mm Hg PaO2 70 mm Hg HCO3− 15 mEq/L
pH low
53
What imbalance is this? pH 7.60 PaCO2 30 mm Hg PaO2 60 mm Hg HCO3− 22 mEq/L
pH high

NUR 520 (12 decks)

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