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PRES 5400

ACP First 4 Weeks

Define an ion. A charged particle.
Define an acid. Liberates hydrogen ions in solution.
Define a base/alkali. Accepts hydrogen ions in solution.
Normal blood values of pH. Arterial Blood. 7.35 - 7.45
Normal blood values of pH. Venous blood and interstitial fluid. ~7.35
Normal blood values of ph. ICF ~6 - 7.35
Homeostasis of hydrogen. Proteins are sensitive to pH. Diets high in protein tend to acidify blood.
What are the 3 mechanisms to regulate pH? Buffer system. Exhalation of CO2 (respiratory system). Kidney excretion of hydrogen (urinary system).
Describe the buffer system. Prevent rapid/drastic changes to pH (shock absorber)
Name the 3 buffer systems. Protein. Carbonic acid - bicarbonate. Phosphate
Describe the protein buffer system. Abundant in intracellular fluids and in plasma. Amino acids contains at least one carboxyl group and one amino group (acts like a acid and a base). Hemoglobin acts as a buffer in blood by picking up CO2 and hydrogen.
Describe the carbonic acid-bicarbonate buffer system. Acts as extracellular and intracellular system. At pH of 7.4, the bicarbonate ion to carbonic acid concentration is 20:1. **This cannot protect against pH changes due to respiratory problems.
What is not scientific nomenclature of the carbonic acid-bicarbonate buffer system. CO2 + HO2 <--> H2CO3 <--> Hydrogen + HCO3-.
Describe the phosphate buffer system. Most important intracellular, but also buffers in the urine.
Describe renal control buffer system. Excretion of hydrogen in urine is the only way to eliminate huge excess. Kidneys make bicarbonate and save filtered bicarbonate.
What are the normal values of the acid base balance? pH 7.35 - 7.45. PCO2 35-45 mmHg. PO2 80-100 mmHg. HCO3 22-28 mEq/L.
What do acid base imbalances present as? Acidosis: depression of CNS - coma. Alkalosis: excitability of nervous tissue (spasms, convulsions, death).
What causes respiratory acidosis/alkalosis? Changes in the partial pressure of CO2. >45 mmHg = acidosis. <35 mmHg = alkalosis.
What causes metabolic acidosis/alkalosis? Changes in bicarbonate ion (HCO3-). <22 mEq/L = acidosis. > 28 mEq/L = alkalosis.
Describe respiratory acidosis. Elevation of CO2. Due to lack of removal of CO2 from blood. Treatment: Ventilate.
Describe respiratory alkalosis. Arterial CO2 is low. Renal compensation involves decrease of hydrogen excretion and increase reabsorption of bicarbonate. Treatment: breath into paper bag.
Describe metabolic acidosis. Blood bicarbonate is low. Loss by diarrhea or kidney dysfunction. Increase acid from diet/diabetes. Kidney fails to remove excess hydrogen from protein metabolism. Treatment: ventilate and correct the cause.
Describe metabolic alkalosis. Blood bicarbonate is high. Cause is a non-respiratory loss of acid (vomit, diuretics, dehydration, intake of alkali drugs). Hypoventilation. Treatment: fluid and electrolyte therapy, correct the cause.
Define milliequivalent. grams of solute in one mL of solution.
What are the two fluid compartments? Intracellular. Extracellular.
Describe Extracellular. 1/3 intravascular. 2/3 interstitial.
Describe the movement between fluid compartments. Intracellular to Interstitial: by diffusion. Intravascular to interstitial: by hydrostatic pressure.
Define osmosis. Movement of water from high to low concentration.
Define hydrostatic pressure. Pressure exerted by the movement or mass of water.
Describe isotonic. solutions are equal on opposite sides of membrane. Red blood cell is normal.
Describe hypertonic. Solute is greater on one side of membrane. Red blood cell shrinks.
Describe hypotonic. Solute is lesser on one side of membrane. Red blood cell bursts.
Describe dehydration. Loss of total body water. Isotonic: salt and water lost is equal (diarrhea, bleeding). Hyponatremic: loss of sodium (sweat, diuretics). Hypernatremic: increased sodium (high sodium diet).
Describe the regulatory mechanism for fluid. Thirst. Autonomic Nervous System: sympathetic response. Hormonal response: antidiuretic hormone, renin-angiotensin-aldosterone.
Describe the antidiuretic hormone. Stimulated by high osmotic pressure in hypothalamic osmoreceptors.
Created by: Grizzlyman