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F&E Quiz
Exam 3
| Question | Answer |
|---|---|
| Cheif acid | carbonic acid (H2CO3) |
| Chief alkaline/base | bicarbonate (HCO3) |
| pH | amount of hydrogen ions in a solution. Ranges from 1 (highly acidic) to 14 (highly basic) |
| The body controls the pH balance by use of? | chemical regulation, oxygen regulation and kidneys |
| What systems regulate our pH level? | Respiratory and Renal |
| Chemical Regulation | * Bicarbonate-carbonic acid buffer system ~ 20 parts of bicarbonate to 1 part carbonic acid and if this ratio is altered the pH will change. * carbonic acid is controlled by lungs * bicarbonate is controlled by kidneys |
| Oxygen Regulation | Lungs: regulate carbonic acid levels by releasing or conserving CO2 by increasing or decreasing the respiratory rate. |
| Kidney Regulation | Kidneys: controls the sodium bicarb by excreting acidic or akaline urine. |
| Compensation | body tries to correct the imbalance in the acids or base and put the pH range back to normal. |
| Buffers | prevent any changes in the extracellular fluid from releasing or accepting a Hydrogen ion and it helps keep pH in balance. |
| Compensation | if an imbalance in acids and bases occur these regulatory processes are accelerated. * If lungs are the problem then kidneys kick in. * If kidneys are the problem then the lungs kick in. |
| Arterial Blood Gas Normal Values | pH, 7.35 - 7.45 PaO2 80 - 100mm Hg PaCO2 35 - 45mm Hg HCO3 22 - 26mm Hg SaO2 95% - 100% |
| pH | pH, hydrogen ion concentration 7.35 - 7.45 |
| PaO2 | * partial pressure oxygen in arterial blood * 80 - 100mm Hg (the force that the O2 gases are putting on vessel walls) |
| PaCO2 | * partial pressure of carbon dioxide in arterial blood 35 - 45mm Hg LINKED TO LUNGS |
| HCO3 | bicarbonate ion concentration in blood 22 - 26mm Hg LINKED TO KIDNEYS |
| SaO2 | arterial oxygen satuartion or % of O2 carrying capacity in the blood 95% - 100% How O2 is riding on Hemoglobin and going out to tissue. |
| Different types of compensation | Complete Compensation Partial (incomplete) Compensation Decompensation |
| Complete Compensation | pH is back in balance....problem has been fixed |
| Partial Compensation | things are improving and getting close to normal but pH is still abnormal. |
| Decompensation | worsening state of ABG's values. spiraling out of control example: after your interventions you do another lab and numbers are still going bad. |
| Four Major Acid-Base Imbalances | Respiratory Acidosis Respiratory Alkalosis Metabolic Acidosis Meatbolic Alkalosis |
| Respiratory Acidosis | pH decrease due to retention of CO2 we're not breathing enough and blowing off CO2 pH is decreased, CO2 is increased. LUNGS |
| Respiratory Alkalosis | pH increases due to excessive loss of CO2 we're breathing too much and blowing off too much of CO2 pH is increased and CO2 is decreased. - LUNGS |
| Metabolic Acidosis | pH decreases due to loss of bicarbonate or excess acid added to body fluids. pH is decreased and HCO3 is decreased. - KIDNEY |
| Metabolic Alkalosis | pH increases due to bicarbonate excess or excessive loss of acid. pH is increased and HCO3 is increased. ~ Kidney |
| R.O.M.E. | R= Respiratory O = Opposite M= Metabolic E= Equal |
| Respiratory Opposite | if pH is decreased then carbonic CO2 is increased, if pH is increased then CO2 is decreased. pH and CO2 ALWAYS are OPPOSITE |
| Metabolic Equal | if pH is decreased then bicarbonate HCO3 is dcreased, if pH is increased then HCO3 is increase. Metabolic is ALWAYS GOING IN SAME DIRECTION |
| Respiratory Acidosis | pH is decreased, PaCO2 is increased Occurs from HYPOVENTILATION because we are not breathing a lot and not able to "blow off" CO2. |
| Respiratory Acidosis Causes: | Pneumonia, COPD, Sedation from anesthsia or drug overdose), Atelectasis, Neuromuscular Disease, Chest trauma |
| Respiratory Acidosis Signs & Symptoms (Cardiac) | decreased BP w/vasodilation warmed flushed skin weak thready pulse tachycardia HYPERkalemia which cause risk of dysrhythmias |
| With Respiratory Acidosis you can expect? | HYPERkalemia |
| Respiratory Acidosis Signs & Symptoms (Respiratory) | SOB hypoxia |
| Respiratory Acidosis Signs & Symptoms (CNS) | headache altered mental status decreased LOC Drowiness may lead to Coma seizures hyperreflexia |
| Respiratory Acidosis Treatment: | Treat the cause Examples: If from sedation give Narcan If from collapse lung put in chest tube If pneumonia give antibiotic |
| Respiratory Acidosis Treatment: | Treat the cause Pulmonary hygiene/toileting Supplemental O2 cautiously |
| Respiratory Acidosis Medication: | Bronchodilators Antibiotics Mucomyst |
| Respiratory Acidosis Teaching: | Deep breathing exercises |
| Respiratory Acidosis Compensation | Increased Respiratory Rate to blow off Co2 and Kidneys will kick in to help eliminate hydrogen ions and exrete more acidic urine. |
| Respiratory Alkalosis | pH is increased and CO2 is decreased. HYPERventilation. We're breathing too fast and "blowing off" too much CO2. |
| Respiratory Alkalosis Causes: | Anxiety (test anxiety, Fear, Panic attacks Pulmonary Embolism Sepsis (severe systemic infection) Salicylate poisioning (ASA) Excessive Mechanical Ventilation (ICU) |
| Respiratory Alkalosis S/S (Cardiac) | Increased myocardia irritability Palpatations increased heart rate (pt very sensitive to DIG) HYPOkalemia HYPOcalcemia |
| Respiratory Alkalosis S/S (Respiratory) | Rapid Shallow breathing |
| Respiratory Alkalosis S/S (CNS) | dizzy light headed increase anxiety difficulty concentrating blurred vision numbness/tingling extremities (parasthesis) |
| Respiratory Alkalosis Treatment: | Treat the cause. Breathe into brown paper bag /rebreather mask Give O2 AntiAnxiety drugs |
| Respiratory Alkalosis Treatment: | Treat the cause: If Anxious: have pt breathe more slowly to allow CO2 to accumulate Brown Paper Bag / Re-breather mask If Sepsis give antibiotic If PE treat FAST If becoming Hypoxia give O2 STAT |
| Respiratory Alkalosis Meds | Anti Anxiety Agents Sedative/Sedation |
Created by:
CSober1
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