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HCT Med-Surg Acid/Ba

HCT Med-Surg Acid/Base imbalance

Normal pH blood 7.35 - 7.45
Intracellular fluid K (potassium) 65%
Extracellular fluid 35% (9% intravascular, 26% interstitial)
Normal Na range 135 - 145 mEq/L
Hyponatremia <135 mEq/L
Hypernatremia >145 mEq/L
Normal K (potassium) 3.5 - 5.0 mEq/L
Hypokalemia <3.5 mEq/L
Hyperkalemia >5.0 mEq/L
Normal serum Ca (calcium) 4.5 - 5.6 mEq/L
Normal total Ca (calcium) 9.0 - 10.5 mg/dL
Ca is split between serum and total? 50/50
50% of Ca is bound to protein
Hypocalcemia <9.0 mg/dL (total) <4.5 (serum) mEq/L
Hypercalcemia >10.5 mg/dL (total) >5.6 mEq/L (serum)
Ca requires Vitamin D for absorption
Ca plays a role in blood clotting, muscle function, nerve impulse tran & cell membrane permeability
Na regulates fluid balance through osmotic pressure
K is major electrolyte in intracellular fluid
Na is major electrolyte in extracellular fluid
Na stimulates conduction of nerve impulses & helps maintain neuromuscular activity
Mg+ (magnesium) normal range 1.5 - 2.5 mEq/L
Hypomagnesemia <1.5 mEq/L (most commonly chronic alcoholism)
Hypermagnesemia >2.5 mEq/L (uncontrolled diabetes, ketoacidosis), antacids
PO4 (phosphate) normal range 1.7 - 2.6 mEq/L
Hypophosphatemia <1.7 mEq/L (most commonly respitory alkalosis, intense prolonged hyperventilation)
Hyperphosphatemia >2.6 mEq/L (most commonly renal failure)
Cl (chloride) normal range 95 - 106 mEq/L
Hypochloremia <95 mEq/L (most commonly vomiting, gastric suction, gastric surg)
Hyperchloremia >106 mEq/L (dehydration)
Buffer attempt to maintain normal pH range.
Osmosis diffusion of water higher to lower concentration
Filtration dissolved substances forced through cell membranes by hydrostatic pressure
Diffusion molecules, gases, liquids or solids from higher to lower concentration
Hypotonic solution cells swell
hypertonic solution cells shrink
Isotonic solution cells do not change
Skin fluid loss insensible 300 - 400 mL/day same as lungs
Total fluid loss/day 2,500 mL/day
Lung fluid loss insensible 300 - 400 mL/day same as skin
GI tract 200 mL/day in feces
Kidney fluid loss 1,200 - 1,500 mL/day
Kidney's play a major role in maintaining fluid balance
ADH (antidiuretic hormone) posterior pituitary gland reabsorb water
Aldosterone adrenal cortex reabsorption of Na
PCO2 or PaCO2 carbon dioxide (partial pressure of)
HCO3 bicarbonate
PCO2 normal range 35 - 45 mmHg at sea level
Respitory acidosis decreased blood pH, increased CO2
Respitory alkalosis increased blood pH, decreased CO2
Metabolic acidosis decreased blood pH, HCO3 & CO2
Metabolic alkalosis increased blood pH, HCO3 & CO2
Most common indicator of fluid volume deficiency thirst
Normal HCO3 (bicarbonate) 24-28 mEq/L
Normal BUN (blood urea nitrogen 5-25 mg/dL
Normal Creatinine 0.5 - 1.5 mg/dL
Normal Protein 6.0 - 8.0 g/dL
Normal albumin 3.5 - 5 g/dL
Blood < 7.35 acidosis
Blood > 7.45 alkalosis
PCO2 > 45 respiratory acidosis
PCO2 < 35 respiratory alkalosis
HCO3 > 26 metabolic alkalosis
HCO3 < 22 metabolic acidosis
COPD Resp. acidosis
sedative or barb. OD Resp. acidosis
pneumonia Resp. acidosis
Atalectasis Resp. acidosis
Resp. acidosis incr. resp, hypotension, weak & thready pulse, tachycardia, warm/flushed skin, h/a, decreased LOC, drowsiness
Hyperventilation Resp. alkalosis
Hypoxia Resp. alkalosis
Fear, fever, pain Resp. alkalosis
exercise, anxiety over vent Resp. alkalosis
Diabetic Ketoacidosis Metabolic acidosis
Lactic acidosis Metabolic acidosis
Starvation Metabolic acidosis
Severe diarrhea Metabolic acidosis
Shock Metabolic acidosis
Severe vomiting Metabolic alkalosis
Excessive NG suctioning Metabolic alkalosis
Diuretic therapy Metabolic alkalosis
Metabolic alkalosis increased heart rate, hypotension, atrial tachcardia, dizziness, respiratory failure, irrability, confusion, tetany, muscle cramps, seizures
Metabolic acidosis Hypotension, cold clammy skin, dysrhythmias, kussmaul's , drowsiness, h/a, confusion, N&V
Resp. alkalosis increased heart rate, syspnea, chest tightness, tetany, seizures, anxiety, panic
Created by: seang

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