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meta Acidosis <HCO3
metabolic acidosis- bicarb deficit- ch 14 p293-298
Question | Answer |
---|---|
Normal pH values | Arterial pH = 7.35-7.45 Mixed Venous = 7.32-7.42 |
Normal PaCO2 values | Arterial PaCO2 = 35-45 mmHg Mixed Venous = 38-52 mmHg |
Normal PaO2 values | Arterial PaO2 = 70-100 mmHg Mixed Venous = 24-48 mmHg |
Normal HCO3- Value | Arterial HCO3- = 19-25 mEq/L Mixed Venous HCO3- = 19-25 mEq/L |
Normal values Oxygen saturation arterial / venous | Arterial O2 sat = >90-95% Venous O2 sat = 40-70% |
Average ABG values pH PaCO2 HCO3- | Average ABG values pH = 7.4 PaCO2 = 40mmHg HCO3- = 24 mEq/L |
serum pH 7.4 = >7.4 = <7.4 = | serum pH 7.4 = normal >7.4 = alkalosis <7.4 = acidosis |
Plasma pH is an indicator of? | Plasma pH is an indicator of hydrogen (H+) ion concentration |
Homeostatic mechanisms that maintain pH... | -Buffer systems -Kidney -Lungs |
The greater H+ concentration the solution is more _______ with _____ pH | The greater the H+ concentration the solution is more ACIDIC with LOWER pH (<7.4) |
The lower the H+ concentration the solution is more ____ with _____ pH | The lower the H+ concentration the solution is more ALKALINE with HIGHER pH (>7.4) |
Buffer systems prevent major changes in the pH of body fluids by... | Buffer systems prevent major changes in the pH of body fluids by... REMOVING OR RELEASING H+ ions. |
Major Extracellular buffer system is the.. | Major Extracellular buffer system is the..BICARBONATE-CARBONIC ACID BUFFER SYSTEM |
ABG's measure/assess which pH buffer system? | ABG's measure/assess BICARBONATE-CARBONIC ACID BUFFER SYSTEM |
Normal ratio of Bicarbonate (HCO3-) Carbonic Acid (H2CO3) | Normal ratio of Bicarbonate (HCO3-)= 20 Carbonic Acid (H2CO3)= 1 20(HCO3-):1 (H2CO3) THE RATIO MAINTAINS pH / not absolute values |
When CO2 is dissolved in water it becomes... | When CO2 is dissolved in water it becomes...CARBONIC ACID (H2CO3) |
Which organ regulates the bicarbonate level in the ECF? | The KIDNEYS regulates the bicarbonate level in the ECF? |
In most ACIDOSIS (<7.4) the kidneys ___ H+ and conserve ___ to help restore pH balance. | In most ACIDOSIS the kidneys EXCRETE H+ and conserve BICARBONATE (HCO3-) to help restore pH balance. |
In most ALKALOSIS (>7.4) the kidneys ___ H+ and conserve ___ to help restore pH balance. | In most ALKALOSIS the kidneys RETAIN H+ and excrete BICARBONATE (HCO3-) to help restore pH balance. |
ECF Carbonic Acid (H2CO3)regulation is controlled by the ... | ECF Carbonic Acid (H2CO3) regulation is controlled by the ...LUNGS (controlled by the medulla) |
How/Why do the lungs control the carbonic acid (H2CO3)level? | The lungs control carbonic acid (H2CO3) by adjusting ventilation in response to the serum CO2 level |
A rise in PaCO2 (partial pressure CO2)is powerful stimulation of... | A rise in PaCO2 (partial pressure CO2)is powerful stimulation of... RESPIRATION |
In metabolic ACIDOSIS (<7.4), the respiratory rate ___, causing ___ of ___. | In metabolic ACIDOSIS, the respiratory rate INCREASES causing ELIMINATON of CO2. |
In metabolic ALKALOSIS (>7.4), the respiratory rate ___ causing ___ of ___. | In metabolic ALKALOSIS, the respiratory rate DECREASES causing RETENTION of CO2. |
low pH = increased ___ and low plasma ___ concentration. | LOW pH = increased H+ and LOW plasma Bicarbonate(HCO3-)concentration. |
Anion Gap is essential in analyzing ___ correctly | Anion Gap is essential in analyzing ACID-BASE DISORDERS correctly |
list the 3 normally unmearsured ECF anions... | Phosphates Sulfates Proteins |
___ is often omitted from the anion gap equation because of its low plasma level. | POTASSIUM is often omitted from the anion gap equation because of its low plasma level. |
Anion gap equations | Anion Gap = Na + K - (Cl + HCO3) anion gap = sodium + potassium (chloride + bicarb) OR Anion Gap = Na - (Cl + HCO3) ag = sodium - (chloride + bicarb) |
Normal anion gap (w/o potassium) VS. Normal anion gap (with potassium) | Normal anion gap (w/o potassium) 8-12 mEq/L / 8-12 mmol/L VS. Normal anion gap (with potassium) 12-16 mEq/L / 12-16 mmol/L |
Normal anion gap ACIDOSIS is also called... | Normal anion gap ACIDOSIS is also called... HYPERCHLOREMIC ACIDOSIS |
Disorders that cause negative/decreased anion gap are... | Disorders that cause negative/decreased anion gap are...RARE (compared to increased/high anion gap) |
HYPERCHLOREMIC ACIDOSIS/Normal anion gap ACIDOSIS results from a direct loss of ___? | HYPERCHLOREMIC ACIDOSIS/Normal anion gap ACIDOSIS results from a direct loss of BICARBONATE (HCO3-) |
HYPERCHLOREMIC ACIDOSIS/Normal anion gap ACIDOSIS may result from what conditions? | HYPERCHLOREMIC ACIDOSIS/Normal anion gap ACIDOSIS may result from: Diarrhea, lower intestinal fistulas, ureterostomies, diuretic use, early renal insufficiency, excess chloride admin, TPN admin w/o bicarb. |
Reduced or Negative anion gap is rare but primarily produced by... | Reduced or Negative anion gap is rare but primarily produced by...HYPOPROTEINEMIA |
S/S OF metabolic acidosis (<7.35): | -headache -confusion -drowsiness -increased resp & depth -nausea / vomiting *Decreased BP, cold clammy skin, dysrthmias, SHOCK. |
What occurs when the serum pH <7 ? | Vasodilation & Decreased Cardiac Output |
****************** The cardinal feature of METABOLIC ACIDOSIS is ... ****************** | The cardinal feature of metabolic acidosis is ... DECREASED SERUM BICARB (ABG: HCO3- = <22mEq/L) |
metabolic acidosis root cause = | metabolic acidosis root cause = base bicarbonate (HCO3-) deficit |
What electrolyte imbalance may coincide with metabolic acidosis? | HyperKalemia may accompany metabolic acidosis, resulting from K+ shifting out of cells into the ECF |
Treatment of metabolic acidosis is.. | -correct cause..i.e.>chloride admin -monitor ECG, ABG, pulse ox -MONITOR SERUM K+ for hypokalemia -hypOKalemia corrected as acidosis reversed |
In chronic metabolic acidosis, low serum ____ levels are treated before acidosis to avoid ____. | In CHRONIC metabolic acidosis, low serum CALCIUM levels are treated before acidosis to avoid TETANY. |
METABOLIC ACIDOSIS(Ph<7.35) INITIAL EVENT: ↓ ph ↓ HCO3- ↓or normal PaCO2 COMPENSATION = ? | METABOLIC ACIDOSIS(Ph<7.35) COMPENSATION = HypERVentilation = ↓PaCO (conserves HCO3-) |