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HCT Med-Surg Acid/Ba
HCT Med-Surg Acid/Base imbalance
| Question | Answer |
|---|---|
| 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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