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NUR 112
Acid base balance
| Question | Answer |
|---|---|
| normal range of pH | 7.35 to 7.45 |
| acidic pH range | less than 7.35 |
| alkalotic pH range | more than 7.45 |
| lactic acid results from | cellular destruction due to lack of oxygen (ex. Cancer, Kidney failure Sepsis, Excessive exercise) |
| where is hydrochloric acid found | stomach secretion |
| carbonic acid results from | dissolved in the blood, separates into carbon dioxide (CO2) and water (H2O) |
| types of bases | BICARBONATE (HCO3) SODIUM HYDROXIDE CALCIUM HYDROXIDE HYDROGEN PHOSPHATE POTASSIUM HYDROXIDE |
| how will bicarbonate (HCO3) react to too much acid (H+) | leads to the BUFFER accepting Hydrogen ions (H+) causing blood to be more balance |
| how will carbonic acid (H2CO3) react to too much base | eads to the BUFFER releasing Hydrogen ions (H+) causing blood to be more balance |
| lung compensation response time | RAPID; within minutes |
| how do lungs respond to increased CO2? | INCREASED CO2 levels stimulate the brain’s respiratory center to effect the LUNGS leading to INCREASED respirations: -Rapid rate -More depth (deep breathing) -C02 levels are DECREASED bringing the pH to a more normal range |
| how do lungs respond to decreased CO2? | DECREASED CO2 depresses the brain’s respiratory center to effect the LUNGS leading to: DECREASED respirations: -Slower rate -Less depth (shallow breathing) -CO2 levels are INCREASED, bringing the pH to a more normal range |
| kidney compensation response time | slower; hours to days |
| how do kidneys respond to acidosis | -Excrete hydrogen ions (acid) -Retain bicarbonate (base) -Base levels are INCREASED, bringing the pH to a more normal range. |
| how do kidneys respond to acidosis | -Retain hydrogen ions (acid) -Excrete bicarbonate (base) -Base levels are DECREASED, bringing the pH to a more normal range. |
| what is respiratory acidosis | Too much ACID in the blood from the LUNGS causing INCREASED levels of CARBON DIOXIDE (CO2 > 45 mmHg) |
| what is respiratory alkalosis | Too much BASE in the blood from the LUNGS causing DECREASED levels of CARBON DIOXIDE (CO2 < 35 mmHg) |
| what is metabolic acidosis | Too much ACID in the blood from the KIDNEYS retaining too much METABOLIC ACIDS and excreting BICARBONATE (HCO3 < 22) |
| what organs can cause metabolic acidosis | kidneys and intestines; Think Bile, Bowel, Bicarb |
| what organs can cause metabolic alkalosis | kidneys and stomach (ex. excess vomitus) |
| what is metabolic alkalosis | Too much BASE in the blood from the KIDNEYS excreting too much METABOLIC ACIDS in urine and retaining BICARBONATE (HCO3 > 26) back into bloodstream or STOMACH excreting METABOLIC ACID |
| acute respiratory acidosis neuro s/s | altered mental status decreased LOC |
| acute respiratory acidosis respiratory s/s | tachypnea (rapid and shallow) |
| acute respiratory acidosis cardiac s/s | tachycardia; dysrhythmias |
| chronic respiratory acidosis s/s | memory loss |
| common causes of respiratory acidosis | foreign body aspiration chest trauma stroke opiate overdose Respiratory conditions (ex: pneumonia, PE, asthma, COPD, sleep apnea) |
| Respiratory alkalosis neuro s/s | altered mental staus decreased LOC lightheadedness numbness and tingling muscle twitching |
| Respiratory alkalosis respiratory s/s | tachypnea (rapid and deep) (Kussmaul) |
| Respiratory alkalosis cardiac s/s | tachycardia; dysrhythmias |
| common causes of respiratory alkalosis | anxiety and panic attacks fever pain hyperventilation from mechanical ventilation |
| metabolic acidosis neuro s/s | altered mental status decreased LOC |
| metabolic acidosis respiratory s/s | tachypnea (rapid and deep) (kussmaul) |
| metabolic acidosis cardiac s/s | tachycardia; dysrhythmias//////// Bradycardia and Hypotension can occur as client goes into Shock |
| metabolic acidosis GI s/s | N/V/ Diarrhea |
| common causes of metabolic acidosis | increased acid production decreased acid secretion increased bicarbonate loss |
| ways body increases acid production | lactic acidosis diabetic ketoacidosis salicylate toxicity |
| what is lactic acidosis | when increased levels of lactic acid occurs in the body from decreased oxygenation conditions (ex. sepsis, trauma, severe heart failure, shock) |
| what is Salicylate toxicity | (ex Aspirin) overdose increases acid levels in the body |
| what is decreased acid excretion result from | renal failure -- kidneys are retaining acids |
| what does increased bicarbonate loss result from | (Think BM----Bile---Base----Bicarbonate) Diarrhea- Ileostomy drainage GI fistulas |
| what is a GI fistula | abnormal connection between two organ or parts of the body, may leak out fluid and cause infections |
| sodium bicarbonate indication | IV ONLY GIVE IN SEVERE CASES (ex. severe renal disease, uncontrolled diabetes, circulatory insufficiency due to shock or severe dehydration, cardiac arrest) |
| sodium bicarbonate complications | too much can lead to metabolic alkalosis |
| what is hemodialysis used for in metabolic acidosis? | for drug toxicity and those with renal failure- removal of acid from blood |
| metabolic alkalosis neuro s/s | Altered Mental Status Decreased LOC Lightheadedness Numbness & Tingling Muscle Twitching |
| metabolic alkalosis respiratory s/s | Bradypnea (slow & shallow) *** NO SNS STIMULATION |
| metabolic alkalosis cardiac s/s | tachycardia; dysrhythmias |
| metabolic alkalosis GI s/s | N/V/ Diarrhea |
| common causes of metabolic alkalosis | increased acid loss increased bicarbonate |
| what is increased acid loss a result of | vomiting Gastric suctioning dieuretics |
| what is increased bicarbonate a result of | Kidney Disease Alkali Ingestion (ex, bleach, battery) Excess Bicarbonate- administration of IV Sodium Bicarbonate is higher risk Excess use of Antacids |
| what is Allens Test? | done to ensure patency of the radial and ulnar arteries. If either is not patent, a stick should not be done at these sites as blood supply to the hand may be compromised |
| normal PCO2 | 35-45 mmHg |
| normal HCO3 | 22-26 mEq/L |
| normal PaO2 | 80-100 mmHg |
| hypoxemia | inadequate O2 in the blood |
| hypoxia | inadequate O2 to the tissues (PaO2 <60) |
| Compensated acid base balance | pH is NORMAL + PCO2 and HCO3 either RISES or FALLS together |
| Partially compensated acid base balance | pH is ABNORMAL + PCO2 and HCO3 either RISES or FALLS together |
| uncompensated acid base balance | pH is ABNORMAL + PCO2 or HCO3 is NORMAL |
Created by:
ginnyfoscue
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