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P&P 2010 Acid base k
P&P 2010 Acid base blanace
| Question | Answer |
|---|---|
| A substance that can release hydrogen (H+) ions. | Acid |
| considered an acid. | Medically, CO2 |
| Converts to carbaminohemoglobin + H + or | When CO2 enters blood: |
| Converts to bicarbonate + H + or | When CO2 enters blood: |
| Combines with water to form carbonic acid (H2 CO3 ) | When CO2 enters blood: |
| Body metabolism – CO2 -13000 – 20000 mmol/day | Sources of Acids |
| Protein metabolism | Sources of Acids |
| Meat main metabolic source of H+ ions | Sources of Acids |
| Fat metabolism – fatty acids (ketones) | Sources of Acids |
| Starvation, strenuous exercise, undiagnosed diabetes | Sources of Acids |
| A substance that can accept H+ ions | Bases (Alkalis) |
| Fruits & vegetables | Sources of Base |
| Bicarbonate - produced in GI mucosa, pancreas | Sources of Base |
| Ammonia - product of amino acid catabolism - converted to urea by liver | Sources of Base |
| Measures acidity or alkalinity (base) of fluids | pH scale |
| pH of 1 | Acid |
| PH of 14 | Base |
| PH of 7 | Neutral |
| the lower the pH | The more H+ ions present |
| pH 7.35 – 7.45 | Arterial blood pH |
| pH 1.0 – 2.0 | Gastric fluid pH |
| pH 7.0 – 8.0 | Small intestine pH |
| pH 4.5 – 6.0 | Urine pH |
| enzyme function | pH of blood must be maintained for: |
| normal metabolism | pH of blood must be maintained for |
| Buffer pairs – respond stat | Mechanisms to Control pH |
| Respiratory System – within 1 – 3 minutes | Mechanisms to Control pH |
| Kidneys – hours – days – but most potent | Mechanisms to Control pH |
| CO2 + H2O is | When CO2 dissolves in H2O, it becomes carbonic acid -----H2CO3 |
| HCO3 + H+ is | When bicarbonate picks up a H+ ion, it becomes carbonic acid |
| Protein – e.g. carbaminohemoglobin | Buffer Pairs |
| Phosphate – phosphates & hydrogen | Buffer Pairs |
| Bone – bone carbonate | Buffer Pairs |
| Respirations slow | Conserves CO2 to lower pH (more acid)---Respiratory System (more acid) |
| Respirations rapid | Eliminates CO2 to raise pH (alkaline) |
| Responds within 1 – 3 minutes to a change in blood pH | Respiratory System |
| 50 – 70% effective in restoring pH | Respiratory System |
| May help correct an imbalance (compensation) | Respiratory System |
| May be the cause of the pH change | Respiratory System |
| Proximal convoluted tubule reabsorbs bicarbonate | Renal Regulation |
| Distal convoluted tubule secretes H+ | Renal Regulation |
| Rids body of phosphoric acid, uric acid, lactic acid, ketone bodies | Renal Regulation |
| Slow response – hours – days | Renal Regulation |
| Very effective at correcting imbalance | Renal Regulation |
| May be cause of pH change | Renal Regulation |
| pH- 7.35 – 7.45 | Arterial Blood Gases |
| paCO2 - 35 – 45 mmHg | Arterial Blood Gases |
| HCO3 - 22 – 26 mEq/L | Arterial Blood Gases |
| paO2 - 80 – 100 mmHg | Arterial Blood Gases |
| SaO2 - 95 – 100% | Arterial Blood Gases |
| acid - acidosis | pH - below 7.35 |
| base - alkalosis | pH- above 7.45 |
| too much CO2 - acid | paCO2 - > 45 |
| not enough CO2 - base | - < 35 – |
| too much bicarb - base | HCO3 - > 26 |
| not enough bicarb - acid | - < 22 |
| respiratory problem | if it is the CO2 |
| metabolic problem | if it is the HCO3 |
| pH - 7.5 paCO2 - 40 HCO3 - 33 | Metabolic alkalosis, Overuse of antacids, Vomiting, Use of K-wasting diuretics |
| pH - 7.1 paCO2 - 80 HCO3 - 25 | Respiratory acidosis, - Causes, Drug overdose, Respiratory depression |
| pH - 7.2 paCO2 - 40 HCO3 - 15 | Metabolic acidosis - Causes, Too much H+ -- Renal failure, Diabetic ketoacidosis Too little bicarb - intense diarrhea |
| intense diarrhea | Too little bicarb |
| pH - 7.5 paCO2 - 25 HCO3 - 25 | Respiratory alkalosis - Causes, Early pneumonia with tachypnea, Hyperventilation |
| pH - 7.3 paCO2 - 80 HCO3 - 40 | Respiratory acidosis with partial compensation, COPD |
| pH - 7.45 paCO2 - 30 HCO3 - 19 | Respiratory alkalosis with complete compensation - Causes, Normal pregnancy |
| low pH | Acidosis |
| Diminishes cardiac contractions | Acidosis |
| Depresses impulse transmission confusion, disorientation, coma | Acidosis |
| Decreases vascular response to catecholamines | Acidosis |
| COPD, chronic asthma | Respiratory Acidosis |
| Additional effects: diaphoresis, cyanosis, irregular pulse | Respiratory Acidosis |
| Accumulation of acids or deficit of bases. | Metabolic Acidosis |
| Usually an endocrine or metabolic disorder. | Metabolic Acidosis |
| Additional effects: headache, drowsiness, vomiting, diarrhea | Metabolic Acidosis |
| high pH | Alkalosis |
| Impaired tissue oxygenation | Alkalosis |
| Impaired neuromuscular function | Alkalosis |
| Increased synaptic transmission | Alkalosis |
| Hyperventilation, ventilators | Respiratory Alkalosis |
| Additional effects: headache, vertigo, syncope, paresthesia | Respiratory Alkalosis |
| Loss of acids - prolonged vomiting, NG suction, long-term diuretics | Metabolic Alkalosis |
| Additional effects: shallow breathing, nausea | Metabolic Alkalosis |
| 7.35 – 7.45 | Arterol blood gas pH- |
| 35 – 45 mmHg | paCO2 |
| 22 – 26 mEq/L | HCO3 |
| 80 – 100 mmHg | paO2 |
| 95 – 100% | SaO2 |
| pH - below 7.35 | acid - acidosis |
| pH- above 7.45 | base - alkalosis |
| low pH | Acidosis |
| high pH | Alkalosis |
| Acid | A substance that can release hydrogen ions is called a (an): |
| Acid | Carbon dioxide is medically considered a (an): |
| Fruits and vegetables | not sources of acids |
| Fat metabolism, Body metabolism, Protein metabolism | sources of acid |
| A substance that accepts hydrogen ions | Base |
| A pH of 7.35-7.45 is the normal pH of: | Arterial Blood |
| The lower the hydrogen ions the more alkaline the solution is. (T or F) | True |
| The more hydrogen ions present, the higher the pH. (T or F) | False |
| The respiratory system is a buffer to control pH and responds within: | One - Three Minutes |
| The most potent mechanism to control acid-base balance is the | Kidneys |
| Lower pH | Slow respirations |
| Increase pH | Fast respirations |
| The proximal convoluted tubule of the nephron reabsorbs | Bicarbonate |
| The distal convoluted tubule reabsorbs hydrogen. (T or F) | False |
| Renal regulation to correct acid-base imbalances takes | Minutes to hours |
| Alkalosis results from a pH below 7.35 (T or F) | False |
| Partial pressure of arterial carbon dioxide below 35 indicates a blood gas that is: | Alkalinic |
| Prolonged nasogastric suctioning may lead to: | Respiratory acidosis |
| pH - below 7.35 is | acid |
| pH- above 7.45 | base |
| paCO2 - greater than 45 | – too much CO2 – acid |
| paCO2 less than 35 – | not enough CO2 – base |
| HCO3 - greater than 26 – | too much bicarb – base |
| HCO3 less than 22 | - – not enough bicarb – acid |
Created by:
kfroel4
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