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Acid/Base

understanding the balancing act

QuestionAnswer
What is an acid? an acid is a substance that can donate a H+ to a base.
What is an example of an acid? Examples include hydrochloric acid, lactic acid, ammonium ion, nitric acid, acetic acid and carbonic acid(H2CO3)
What is a base? A base is a substance that can accept or bind to a H+.
What is an example of a base? An example of a base is ammonia, lactate, acetate and bicarbonate. (HCO3)
What is pH?/what does it reflect? pH reflects the overall + concentration in body fluids. The higher the number of H+ in the blood, the lower the pH and the lower the # of H+ in the blood, the higher the pH.
What is the pH of blood? Blood is slightly alkaline and has a normal range of 7.35-7.45
What are the effects of acidic blood on the body? Acidic blood forces cardiac contractions to diminish.
What are the effects of alkaline blood on the body? Akaline blood will impair neuromuscular function.
What are the body's 3 regulating systems for maintaining pH? Chemical buffer system, respiratory system and the renal system.
Explain the chemical buffer system. Chemical buffers are substances that combine with excess acids or bases, act immediately to maintain pH ad are the body's most efficient pH balancing force.
Where are chemical buffers located? Chemical buffers are located in the blood, intracellular and extracellular fluid.
What are the main chemical buffers? The main chemical buffers are bicarbonate, phosphate and protein.
Explain the respiratory system as a regulating system The lungs regulate carbon dioxide (CO2) in the blood, which combines with H2O to form (H2CO3). Chemoreceptors in the brain sense pH changes and vary the rate and depth of respirations to regulate CO2 levels.
Understanding the mechanisms of the lungs Faster deeping breathing eliminates CO2 from the lungs and less H2CO3 is formed so pH rises.
Understading the mechanisms of the lungs II Slower, shallower breathing reduces CO2 excretion so pH falls. This system responds in minutes.
What is PaCO2? PaCO2 is the partial pressure of arterial CO2 which reflects CO2 in the blood. Normal Paco2 is 35-45mmHG
Understanding Paco2. A higher CO2 level indicates hypoventilation from shallow breathing and a Lover Paco2 level indicates hyperventilation.
Explain the renal system as a regulating system. The renal system maintains acid-base balance by absorbing or excreting acids and bases. The kidneys also pro
Understanding the mechanisms of the kidneys. The kidneys produce HCO3 to relenish lost supplies. Normal levels are 22-26mEq/l.
How kidneys work on acid When blood is acidic the kidneys reabsorb HCO3 and excrete H+. When the blood is Alkalotic the kidneys excrete HCO3 and retain the H+. They take 24hrs to begin to restore normal pH.
What is acidosis? Acidosis is when the blood has too much acid or not enough base.
What is alkalosis? Alkalosis is when the blood has too much alkaline or not enought acid.
Recoginizing when the respiratory system is at fault. If the respiratory system is at fault, you will detect it by reveiwing the Paco2 levels. If the metabolic system is at fault you will detect it in the serum HCO3 levels.
Respiratory acidosis Respiratory acidosis causes a pH below 7.35 and a Paco2 above 45mm hg. HCO3 is normal
Causes of Respiratory acidosis Hypoventilation, respiratory acidosis develops when the lungs don't adequately eliminate CO2.
Respiratory alkolis Respiratory alkalosis causes a pH higher than 7.45 and a Paco2 below 35mm Hg but HCO3 is normal.
Causes of Respiratory alkalosis Hyperventilation, respiratory alkalosis develops when the lungs eliminate too much CO2. Most common cause is anxiety.
Metabolic acidosis Metabolic acidosis cause a HCO3 below 22mEq/L and a pH below 7.35. Paco2 is normal.
Causes of metabolic acidosis Metabolic acidosis may be a result of injestion of acidic substance or substance that can be metobolized to an acid, production of excess acid, inability of kidneys to excrete normal acid, or loss of base.
Metabolic Alkalosis Metabolic alkalosis causes a HCO3 above 26mEq/L and a pH above 7.45 with a normal Paco2.
Causes of metabolic Alkalosis Metabolic alkalosis may be a result of loss of stomach acid, an excess loss of sodium or potassium, a renal loss of H+ or a gain of base.
Understanding compensation To regain acid-base balance, the lungs may respond to a metabolic disorder and the kidneys may respond t a respiratory disorder.
Understanding Compensation II (partial compensation) If pH remains abnormal, the respiratory or metabolic response is called partial compensation.
Understanding compensationIII (complete compensation) If pH returns to normal the response is complete compensation.
Step 1 in interpreting ABG List the results for the three essential valuse, pH, Paco2 and HCO3.
Step 2 in interpreting ABG Compare them with normal values. If a result indicates execessive acid, write an A next to it. If it indicates excessive base write a B next to it and if normal write an N next to it. pH tells if pt is acidic or alkalotic
Step 3 in interpreting ABG If you have written the same letter for 2 or 3 results, circle them. if you circle ph and Paco2, pt has a respiratory disorder. If you circle pH and HCO3 your pt has a metabolic disorder. If you cirle all 3 pt has combined disorder.
Step 4 To check compensation, look at the result you did not circle, if it has moved in the opposite direction of those circled compensation is occurring. if value remains in the normal range, no compensation is occurring.
Created by: yvetteymj8
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