ACID BASE DISTURBANCES

Question 1

Indicator of H+ Concentration, reflects acidity or alkalinity in blood

Answer 1

Plasma pH

Question 2

Normal plasma PH is

Answer 2

7.35-7.45

Question 3

What are the plasma PH homeostatic mechanisms?

Answer 3

-Buffer System
- Kidneys
- Lungs

Question 4

Prevents major changes in the pH of body fluids

Answer 4

Buffer System

Question 5

Carbonic acid buffer system

Answer 5

Bicarbonate

Question 6

Removes or releases H+

Answer 6

Buffer System

Question 7

What is the ratio of bicarbonate to carbonic acid buffer system

Answer 7

20:1

Question 8

It is regulated by the kidneys

Answer 8

Bicarbonate (HCO3)

Question 9

It is regulated by the lungs

Answer 9

Carbonic Acid

Question 10

Regulate the bicarbonate level in the ECF

Answer 10

Kidneys

Question 11

Able to regenerate bicarbonate ions and/or reabsorb the ions from the renal tubular cells

Answer 11

Kidneys

Question 12

A base bicarbonate deficit

Answer 12

Metabolic Acidosis

Question 13

Occurs when an acid other than carbonic acid accumulates in the body or when bicarbonate is lost from body fluids.

Answer 13

Metabolic Acidosis

Question 14

What are the causes of metabolic acidosis? (DSLR)

Answer 14

-Diabetes Ketoacidosis
-Severe diarrhea
-Lactic acidosis
- Renal disease

Question 15

Clinical Manifestations of Metabolic Acidosis

Answer 15

-Kussmaul respiration (deep, rapid breathing)
- Peripheral vasodilation (warm, flushed skin)
- Hypotension
- Hyperkalemia
- Dysrhythmia
- N&V
- Headache
-Drowsiness
-Confusion
-Coma

Question 16

Why fluid replacement is important in the collaborative management of metabolic acidosis?

Answer 16

because water loss may result from hyperventilation

Question 17

What drugs are appropriate for metabolic acidosis?

Answer 17

Sodium bicarbonate

Question 18

A base bicarbonate excess

Answer 18

Metabolic Alkalosis

Question 19

Occurs when a loss of acid or gain in bicarbonate occurs

Answer 19

Metabolic Alkalosis

Question 20

Causes of Metabolic Alkalosis? (SPEED)

Answer 20

-Severe vomiting
- Potassium deficit
-Excessive gastric suction
- Excess sodium bicarbonate suction
- Diuretic therapy

Question 21

Clinical Manifestations of Metabolic Alkalosis

Answer 21

Hypoventilation
Tachycardia
Hypokalemia
Dysrhythmia
Tetany
Seizures
Dizziness
Confusion
Headache

Question 22

What happens when hypocalcemia develops as alkalosis damages ionized calcium?

Answer 22

Tetany

Question 23

What solutions must be administered in metabolic alkalosis?

Answer 23

Administer sodium chloride solutions

Question 24

Drugs for Metabolic Alkalosis

Answer 24

-Cimetidine (Tagamet)
- Acetazolamide (Diamox)

Question 25

H2 receptor agonist and reduces the production of gastric hydrogen chloride

Answer 25

Cimetidine (Target)

Question 26

Carbonic anhydrase inhibitor and increases excretion of bicarbonate by the kidneys

Answer 26

Acetazolamide (Diamox)

Question 27

A carbonic acid excess

Answer 27

Respiratory Acidosis

Question 28

Occurs when a person hypoventilates

Answer 28

Respiratory Acidosis

Question 29

What are the causes of respiratory acidosis? (SCAN COMB)

Answer 29

Severe pneumonia COPD Atelectasis Neuromuscular disorders Chest wall abnormalities Opioid overdose Mechanical hypoventilation Barbiturate overdose

Question 30

Respiratory Acidosis Clinical Manifestations

Answer 30

-Tachycardia, tachypnea -Increased BP - Confusion -Feeling of fullness in the head - Decreased LOC

Question 31

The appropriate position in respiratory acidosis is

Answer 31

Semi-fowlers postion

Question 32

Carbonic acid deficit

Answer 32

Respiratory Alkalosis

Question 33

Occurs with hyperventilation

Answer 33

Respiratory Alkalosis

Question 34

Hyperventilation manifests:

Answer 34

-Hypoxia -Pulmonary embolism - Anxiety - Fear -Pain - Exercise -Fever

Question 35

Respiratory Alkalosis Clinical Manifestations

Answer 35

-Dizziness -Confusion -Headache -Tachycardia -Dysrhythmia - Hypokalemia -Nausea and vomiting - Epigastric Pain - Tetany -Seizures

Question 36

Nursing responsibilities when the patient experiences hyperventilation

Answer 36

Let the patient breath into paper bag or cupped hands