Chapter 6: acid base balance

Question 1

What are buffers of pH?

Answer 1

Chemicals that combine with an acid or base to change pH

Question 2

What do buffers do?

Answer 2

Immediate reaction to counteract pH variations until compensation is initiated

Question 3

What are the four major buffer mechanisms?

Answer 3

Four major buffer mechanisms—the bicarbonate–carbonic acid system, phosphate system, hemoglobin system, and protein system

Question 4

Where is the Bicarbonate–Carbonic Acid System most significant?

Answer 4

Most significant in the extracellular fluid.

Question 5

What are the key players in the Bicarbonate–Carbonic

Acid System?

Answer 5

Carbonic acid and bicarbonate are the key players.

Question 6

How does carbonic acid form?

Answer 6

Carbonic acid forms from carbon dioxide reacting with water.

Question 7

What is the equation of acid base compensation?

Answer 7

CO2 + H2O H2CO3 H+ + HCO3−

Question 8

What does potassium do to maintain pH?

Answer 8

Potassium and hydrogen move interchangeably into and out of the cell to balance pH.

Question 9

What happens with extracellular excess of potassium?

Answer 9

With extracellular excess, hydrogen moves inside the cell for buffering; in exchange, potassium moves out.

Question 10

Can potassium imbalances lead to pH imbalances?

Answer 10

yes

Question 11

What does respiratory regulation do to maintain pH

Answer 11

Manages pH by altering carbon dioxide excretion.

Question 12

What does breathing faster do to pH?

Answer 12

Breathing faster will excrete more carbon dioxide, decreasing acidity.

Question 13

What does breathing slower do to pH?

Answer 13

Breathing slower will excrete less carbon dioxide, increasing acidity.

Question 14

What does respiratory regulation use?

Answer 14

chemoreceptors

Question 15

Is respiratory regulation fast or slow?

Answer 15

fast

Question 16

What does renal regulation do to maintain pH?

Answer 16

Alters the excretion or retention of hydrogen or bicarbonate

Question 17

When is renal regulation more effective?

Answer 17

More effective as hydrogen removed

Question 18

Is renal regulation fast or slow?

Answer 18

Responds the slowest

Question 19

What does compensation do to maintain pH?

Answer 19

Diseases are compensated by different organs in the bodies

Question 20

Where are metabolic diseases compensated for?

Answer 20

Metabolic disease is compensated by the lungs.

Question 21

If kidney disease impairs acid excretion what do the lungs do?

Answer 21

get rid of excess acid as CO2

Question 22

Where is pulmonary disease compensated?

Answer 22

the kidneys

Question 23

If pulmonary disease impairs excretion of CO what do the kidneys do?

Answer 23

retain bicarbonate and excrete H

Question 24

What is the arterial blood gas value of pH?

Answer 24

7.35-7.45

Question 25

What is the arterial blood gas value of PCO2?

Answer 25

35-45 mm Hg

Question 26

What is the arterial blood gas value of PO2?

Answer 26

80 -100 mmHg

Question 27

What is the arterial blood gas value of HCO^3?

Answer 27

22-26 mEq/L

Question 28

What happens when there is a respiratory acid base imbalance?

Answer 28

impaired ventilation

Question 29

What are the acid base imbalances with respiratory acidosis?

Answer 29

low ph and high pco2

Question 30

What are the acid base imbalances with respiratory alkalosis?

Answer 30

high ph and low pco2

Question 31

What happens when there is a metabolic acid base imbalance?

Answer 31

renal issues

Question 32

What are the acid base imbalances with metabolic acidosis?

Answer 32

low ph and low hco3

Question 33

What are the acid base imbalances with metabolic alkalosis?

Answer 33

high ph and high hco3

Question 34

What would be the mixed combinations of primary imbalances?

Answer 34

low ph high pco2, and low hco3 high ph low pco2, and high hco3

Question 35

How do you compensate for respiratory acidosis?

Answer 35

high hco3

Question 36

How do you compensate for respiratory alkalosis?

Answer 36

low hco3

Question 37

How do you compensate for metabolic acidosis?

Answer 37

low pco2

Question 38

How do you compensate for metabolic alkalosis?

Answer 38

high pco2

Question 39

What causes respiratory acidosis?

Answer 39

Caused by conditions that result in hypoventilation or decreased gas exchange -Include pulmonary disease/infection, airway obstructions, pulmonary edema, drug overdose, respiratory failure, and nervous system depression

Question 40

What are the manifestations of respiratory acidosis?

Answer 40

- Appear as regulatory systems fail to maintain pH within normal range - Occur in combination with manifestations of underlying condition - Include disorientation, lethargy, coma, decreased vascular tone, decreased myocardial contractility, dysrhythmias

Question 41

What are the causes of respiratory alkalosis?

Answer 41

Caused by conditions that result in hyperventilation | -Include acute anxiety, pain, fever, hypoxia, medications, and hypermetabolic states

Question 42

What are the manifestations of respiratory alkalosis?

Answer 42

- Appear as pH outside of normal range - Occur with manifestations of underlying condition - Include dizziness, seizures, and coma (decreased cerebral blood flow)

Question 43

What are the causes of metabolic acidosis?

Answer 43

Causes Bicarbonate deficit: intestinal and renal losses Acid excess: tissue hypoxia resulting in lactic acid accumulation (anaerobic metabolism, hypermetabolism), ketoacidosis (DKA, alcoholism, starvation), and renal retention

Question 44

What are the manifestations of metabolic acidosis?

Answer 44

- Appear as pH outside of normal range - Occur with manifestations of underlying condition - Include fatigue, coma, nausea, vomiting, hypotension, dysrhythmias, Kussmaul’s respirations, and hyperkalemia

Question 45

What is the anion gap and what is it helpful with?

Answer 45

- Identifies the anions that are not measured. | - Helpful in determining the cause of metabolic acidosis.

Question 46

What will increase the anion gap?

Answer 46

conditions that cause the excess acid

Question 47

What are the causes of metabolic alkalosis?

Answer 47

Excess bicarbonate: excessive antacid use, use of bicarbonate-containing fluids Deficient acid: gastrointestinal loss, hypokalemia, renal loss, hypovolemia

Question 48

What are the manifestations of metabolic alkalosis?

Answer 48

Appear as pH outside of normal range Occur with manifestations of underlying condition Include mental confusion, hyperactive reflexes, seizures, respiratory depression, dysrhythmias

Question 49

What is the arterial blood gas interpretation of pH?

Answer 49

serum hydrogen concentration | Indicates acid–base status

Question 50

What is the arterial blood gas interpretation of PaCO2?

Answer 50

partial pressure of carbon dioxide | Indicates the adequacy of pulmonary ventilation

Question 51

What is the arterial blood gas interpretation of HCO3?

Answer 51

bicarbonate | Indicates the activity in the kidneys to retain or excrete bicarbonate

Question 52

What is the arterial blood gas interpretation of PaO2?

Answer 52

partial pressure of oxygen | Indicates serum oxygen concentration