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Acid-Base Imbalances Flashcards

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1
Q

extracellular fluid (ECF)

A

fluid outside cell

20% of body wt.

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2
Q

TBW

A

sum of fluids w/in body

60% of body wt.

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3
Q

interstitial fluid

A

fluid around cells

outside bld vessels

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4
Q

intravascular fluid

A

blood plasma

w/in bld vessels

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5
Q

intracellular fluid (ICF)

A

fluid inside cell

40% of body wt.

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6
Q

diffusion

A

mvmt of charged/noncharged particles along conc. gradient

high to low conc.

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7
Q

osmosis

A

passive mvmt of water across semi-permeable membrane

low to high conc.

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8
Q

osmotic pressure

A

pressure required to stop osmotic flow of water

determined by solutes, osmolality, and osmolarity

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9
Q

osmolality

A

conc of mlcls per wt.

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10
Q

osmolarity

A

conc of mlcls per L

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11
Q

hydrostatic pressure

A

force of water pushing against cellular membranes

force that moves water out

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12
Q

oncotic pressure

A

pressure exerted by colloids- plasma proteins

draws water

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13
Q

inc oncotic pressure

A

draws water out to vasc. space

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14
Q

mvmt of water b/w ICF and ECF

A

occurs by osmotic forces
Na- ECF osmotic balance
K- ICF osmotic balance

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15
Q

mvmt of water b/w plasma and interstitial fluid

A

occurs due to changes in hydrostatic pressure (pushes water out of caps) and osmotic forces (pulls water in caps)

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16
Q

edema

A

accumulation of fluid in interstitial spaces.

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17
Q

etiology of edema

A

inc hydrostatic press
dec plasma oncotic press- give albumin
inc cap permeability
obstructed lymph flow

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18
Q

regulation of body water

A

thirst

renal- ADH

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19
Q

what is thirst stimulated by

A

hyperosmolality, low k, dec BV

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20
Q

how does renal- ADH regulate body water

A

ADH causes kidneys to retain water.

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21
Q

what is renal- ADH controlled by

A

osmolality and volume

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22
Q

when is ADH secreted

A

when osmolality inc, BV dec

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23
Q

normal osmolality

A

280-294

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24
Q

for excess water

A

274

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25
for concentrated fluids, deficit of fluids
299
26
ECF deficit shows what
inc osmolality
27
what does inc osmolality mean
lots of particles in bld, not a lot of fluid
28
etiology of ECF deficit
dec intake | inc loss
29
CM for ECF deficit
``` thirst weight loss dec UO inc HR weakness shock dec plasma vol dec vasc vol tired weak pulse ```
30
treatment for ECF deficit
give fluid- water or IV
31
ECF excess shows what
dec osmolality (<280)
32
etiology of ECF excess
inc intake, dec loss
33
CM for ECF excess
``` weight gain peripheral edema SOB abd distention seizures, coma, swollen brain cells ```
34
treatment for ECF excess
diuretics, water restrictions, depends on underlying problem
35
function of elytes
regulate water balance, needed for enzymatic rxns, acid-base balance
36
function of Na
maintain osmolality of ECF, neuromuscular function, acid-base.
37
Na regulated by
aldosterone | dec Na= inc aldosterone= Na retention.
38
how do we lose Na
sweat, urine, bowel
39
how do we get Na
diet
40
hyponatremia
deficient Na
41
etiology of hyponatremia
excess water intake/gain dec water loss inc Na loss
42
CM for hyponatremia
``` weight gain neuro changes (confusion, lethargy, coma) HA GI disturbances inc intracellular fluid ```
43
treatment for hyponatremia
``` fluid restrictions (H20) inc Na intake (food, IV) ```
44
hypernatremia
excess Na
45
etiology of hypernatremia
inc water loss dec intake of water excess Na
46
CM of hypernatremia
``` thirst dry mucus membranes inc HR restlessness dehydration agitation ```
47
treatment for hypernatremia
Na restrictions | IV fluid low in Na followed by diuretics
48
function of K
``` osmolarity of ICF neuromuscular control and regulation acid-base balance enzyme rxn HR ```
49
how do we get K
diet
50
how do we lose K
from kidneys- urine
51
hypokalemia
deficient K
52
etiology of hypokalemia
dec intake excess GI loss excess renal loss intracellular shift- alkalosis
53
CM for hypokalemia
``` cardiac dysrhythmias weakness dec GI motility PVC fatigue sm. muscle weakness/skel. muscle weakness confusion ```
54
treatment for hypokalemia
give K | IV fluids that contains K supplements
55
hyperkalemia
excess K
56
etiology of hyperkalemia
excess intake/gain dec renal loss extracellular shift- acidosis
57
most common cause of hyperkalemia
dec renal loss
58
CM for hyperkalemia
``` EKG changes cardiac arrest muscle weakness arrythmias PVC inc sm. muscle activity diarrhea cramping ```
59
treatment for hyperkalemia
dec K in fluid/foods diuretics (NOT IF HAVE RENAL FAILURE) insulin oral solution- resin
60
what happens when K is too high
fatal
61
acidosis
process causing acidemia | acid condition of blood pH < 7.35
62
alkalosis
process causing alkalemia | alkaline condition of blood pH > 7.45
63
regulation of pH
carbonic acid- bicarbonate buffering | respiratory or metabolic
64
respiratory mech. of regulating pH
regulates level of C02= acid
65
resp. acidosis
inc C02 due to hypoventilation
66
resp. alkalosis
dec C02 due to hyperventilation
67
metabolic mech. of regulating pH
regulate bicarb (HC03)= base
68
metab. alkalosis
inc bicarb
69
metab. acidosis
dec bicarb
70
normal pH level
7.35 - 7.45
71
normal paC02
35 - 45
72
normal bicarb
22 - 26
73
patho of respiratory acidosis
retain C02 so pH < 7.35
74
etiology of respiratory acidosis
hypoventilation
75
CM for respiratory acidosis
``` depressed CNS confusion HA weakness twitching shallow respiration ```
76
compensation for respiratory acidosis
acid urine
77
treatment for respiratory acidosis
hyperventilate inc breathing bronchodilators get out C02
78
respiratory alkalosis
blow off C02 so pH > 7.45
79
etiology of respiratory alkalosis
hyperventilation
80
CM for respiratory alkalosis
excited CNS- dizzy, confused numb/tingly toes/fingers palpitations sweating
81
compensation for respiratory alkalosis
alkaline urine- lose bicarb
82
treatment for respiratory alkalosis
inc C02 | paper bag
83
metabolic acidosis
retain acid so HC03 dec, pH < 7.35
84
etiology of metabolic acidosis
``` renal failure diarrhea shock (lactic acid) severe hypoxia ketoacidosis (excess glucose) ```
85
CM for metabolic acidosis
``` SAME AS RESP. ACIDOSIS depressed CNS weak fatigue confusion ```
86
compensation for metabolic acidosis
inc RR Kussmaul respirations acid urine
87
treatment for metabolic acidosis
treat underlying problem | give Na bicarb to keep acid-base balanced (IV or tablet)
88
metabolic alkalosis
loss of acid so HC03 inc, pH > 7.45
89
etiology of metabolic alkalosis
``` ingestion of base excessive use of antacids vomitting excess aldosterone diuretic therapy ```
90
CM for metabolic alkalosis
``` RELATED TO RESP ALKALOSIS excited CNS (tingling, cramping) hyperreflexes convulsions weakness confusion ```
91
which acid-base imbalance is least common
metabolic alkalosis
92
compensation for metabolic alkalosis
dec RR | alkaline urine
93
treatment for metabolic alkalosis
self-correcting ID cause restore fluid balance
94
normal Pa02 level
80-100
95
ABG
arterial blood gases | tells us C02, 02, pH, bicarb
96
steps to analyzing ABG
1. look at pH- acidemia or alkalemia 2. find primary cause- look at PaC02 and HC03 3. look at other values to see if compensation
97
if C02 off and matches pH change
respiratory
98
if HC03 off and matches pH change
metabolic

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