Respiratory - Unit 3 - Acid/Base Imbalances

Question 1

pH = 
CO2 =
PaCO2 = 
O2 = 
PaO2 = 
HCO3 =

Answer 1

pH = The chemical abbreviation for negative logarithm of hydrogen ion concentration.
CO2 = Carbon Dioxide
PaCO2 = Pressure of dissolved CO2
O2 = Oxygen
PaO2 = Pressure of dissolved oxygen.
HCO3 = Bicarbonate

Question 2

What are some buffers against H+?

Answer 2

Bicarbonate (HCO3), Phosphorus (H3PO4), Protein (Hemoglobin)

Question 3

Hyperventilate = PCO2 = __ & ___.

Hypoventilate = PCO2 = ___ & ___.

CHANGES OCCUR IN ???

Answer 3

Lost & alkaline.

Retained & acid.

MINUTES!!!

Question 4

With excessive acid formation, the respiratory center in the medulla is stimulated, which results in increased depth/rate of respirations, which leads to __ level of CO2

Answer 4

Decreased.

Question 5

With excessive base formation, the respiratory rate slows to promote ___ levels of CO2.

Answer 5

Increased

Question 6

If the RESPIRATORY system is the source of the pH problem, it loses the ability to correct the problem. T/F?

Answer 6

True!

Question 7

HCO3 Reabsorbed = ?

Answer 7

Alkaline

Question 8

HCO3 Excreted = ?

Answer 8

Acid

Question 9

Changes for renal occur in ???

Answer 9

Hours!

Question 10

In acidosis, H+ is excreted in the kidney before K+ions causing ___kalemia.

Answer 10

Hyperkalemia.

Question 11

In alkalosis (decreased H+), H+ is retained and K+ ions are excreted causing _____kalemia.

Answer 11

Hypokalemia.

Question 12

If the renal system is the cause of the pH problem, it loses it’s ability to correct the problem. T/F?

Answer 12

True!

Question 13

What are some ABG Arterial Sites?

Answer 13

Brachial, radial (art line/common), femoral (art line) - GREATEST CHANCE OF HEMORRHAGE HERE

Question 14

What is the ALLEN test?

Answer 14

shows rather patency of radial of ulnar artery is normal. You compress radial artery and ulnar artery —-> release ulnar artery and check circulation to hand.

DO NOT USE radial artery if poor circulation — could lead to loss of hand!

Question 15

What is the normal pH range?

Answer 15

7.35-7.45

Question 16

Increased pH = ?

Decreased pH = ?

Answer 16

Increased = Alkalotic
Decreased = Acidotic

Question 17

pH of 6.8-7.8 is INCOMPATIBLE with life. T/F?

Answer 17

False - it is compatible but probably means they won’t make it.. :(

Question 18

PCO2 Normal =
HCO3 Normal =
PO2 Normal =
O2 Sat Normal =

Answer 18

PCO2 Normal = 35-45 (Ventilation)
HCO3 Normal = 22-26 (Renal)
PO2 Normal = 80-100 (O2 in Plasma)
O2 Sat Normal = 95-100% (Amount of O2 in Hemoglobin)

Question 19

What occurs in metabolic alkalosis?

Answer 19

Increased pH, increased HCO3

Question 20

What happens in metabolic acidosis?

Answer 20

Decreased pH, decreased HCO3

Question 21

If acidic, increased PCO2 =, decreased HC03 =

Answer 21

Increased PC02 = respiratory

Decreased HCO3 = Metabolic

Question 22

If alkaline, decreased PCO2 =, decreased HCO3 =

Answer 22

Decreased PCO2 = Respiratory

Decreased HCO3 = Metabolic

Question 23

If the results are borderline, we know what they are by leaning. T/F?

Answer 23

True - like if it’s 7.35, it’s LEANING towards acid.

If it’s 7.45, it’s leaning toward alkalosis!

Question 24

Decreased O2 sat = Acid or alkalosis?

Decreased PO2 = Acid or alkalosis.

Answer 24

Both acid!

Question 25

What is a primary acid/base disorder?

Answer 25

It's SIMPLE - due to one cause and affects only ONE part of the buffer system (compensatory changes occur in the other part of the system)

Question 26

What is a MIXED acid/base disorder?

Answer 26

Number of combinations of respiratory & metabolic disturbances - disturbance in one part of the system is intensified by superimposed disorder.

Question 27

With respiratory acidosis, what are some hypoventilation disorders that might cause it?

Answer 27

COPD, Obstructed airway, pulmonary edema, pneumonia, head injuries/strokes, hemothorax, cardio-pulmonary arrest, drug overdose, etc.

Question 28

What are some symptoms of respiratory acidosis?

Answer 28

Respirations slow and ineffective, tachy/irregular pulse, restlessness/confusion, SOB w/exertion, headache, paralysis, tremors, arrhythmia's, N/V, cyanosis, increased ICP/coma.

Question 29

How do we treat respiratory acidosis?

Answer 29

CORRECT CAUSE - give fluids with IV KCL, O2 therapy, bronchodilators, chest PT, antibiotics, avoid narcotics and sedation, etc.

Question 30

Respiratory Alkalosis (decreased pCO2, increased pH) - What are some hyperventilation disorders that might cause this?

Answer 30

Fear, pain, anxiety, pneumonia, pulmonary emboli, CVA, high altitude anoxia, ASA poisoning (early), fever/septicemia, excessive CMV

Question 31

What are some respiratory alkalosis symptoms?

Answer 31

RAPID RESPIRATIONS, hyperreflexia, tingling in fingers and toes, irregular pulse/respirations, lightheadedness, dyspnea, anxiety/panic, convulsions.

Question 32

What are some treatment options for respiratory alkalosis?

Answer 32

Correct cause!, rebreathe CO2, decrease activity, sedatives, decadron (steroid), diuresis, CMV

Question 33

What are some dehydration disorders that cause Metabolic Acidosis (Decreased bicarb, decreased pH)

Answer 33

DIABETES (Ketoacidosis), shock, severe diarrhea, GI Suction, systemic infections, pancreatitis, HA/Saline IV, Renal failure.

Question 34

What are some metabolic acidosis symptoms?

Answer 34

KUSSMAUL respirations (deep and labored), headache w/restlessness, apathy/depression, hypotensions, warm & flushed skin, weakness, abd. pain, N/V/Anorexia

Question 35

How do we treat Metabolic Acidosis?

Answer 35

CORRECT CAUSE, IV/Oral HCO2, o2 therapy with CMV, replace insulin/K+/fluids, increase kidney function, increase isotonic fluid volume, assess loc & prevent injury, etc.

Question 36

Metabolic Alkalosis (Increased HCO3, Increased pH) - what causes it?

Answer 36

Reduced K+, by things like GI Suction, vomiting, diuretics, prolonged steroid therapy, excessive bicarb intake

Question 37

What are some Metabolic Alkalosis Symptoms?

Answer 37

CNS Excitability, Slow/Shallow respirations, irregular/tachy pulse, hypotension, numbness, tetany ---> convulsions, lethargy/weakness, disorientation

Question 38

How do we treat Metabolic Alkalosis?

Answer 38

CORRECT CAUSE, NaCl & KCL IV Replacement, Acidifying Meds --> Acidifying Salts, Hydrochloride