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meta Acidosis

metabolic acidosis- bicarb deficit- ch 14 p293-298

QuestionAnswer
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-)

Created by: rtcdavis