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meta Alkalosis >HCO3
metabolic alkalosis -bicarb excess- acid/base disturbance ch 14 p293-298
| Question | Answer |
|---|---|
| Normal pH values | Arterial pH = 7.35-7.45 Mixed Venous = 7.32-7.42 |
| 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 regulate the bicarbonate level in the ECF? |
| Normal PaCO2 levels | Normal PaCO2 levels Arterial PaCO2 35-45 mmHg Venous PaCO2 38-52 mmHg |
| Metabolic ALKALOSIS is characterized by... | -high serum pH (>7.45) (low H+ concentration) -high plasma Bicarbonate/HCO3= >26mEq/L |
| Metabolic ALKALOSIS can be produced by __ or __ | Metabolic ALKALOSIS can be produced by GAIN OF BICARB or LOSS OF H+ |
| ********** most common cause of metabolic ALKALOSIS is ********** | ************** -vomiting -gastric suction / loss of H+ & Cl+ ********************* |
| Normal gastric fluid pH | Normal gastric fluid pH = 1-3 highly acidic |
| loss of gastric fluids increases... | loss of gastric fluids increases the ALKALINITY OF BODY FLUIDS |
| potassium wasting diuretics and excessive adrenocorticoid hormone increase risk of ... | potassium wasting diuretics and excessive adrenocorticoid hormone increase risk of ...METABOLIC ALKALOSIS |
| In what 2 ways does Hypokalemia produce alkalosis? | hypokalemia = Kidneys: conserve K+ / excrete H+ ICF K+: leaves cells (H+ enter) |
| Antacids w. bicarb and sodium bicarb during CPR may cause.. | Antacids w. bicarb and sodium bicarb during CPR may cause METABOLIC ALKALOSIS |
| Chronic metabolic alkalosis can occur with: | -LT diuretic therapy (thiazides/furosemide) -villous adenoma -external drainage of gastric fluid -significant K+ depletion -cystic fibrosis -chronic intake of milk & calcium carbonate |
| S/S of metabolic ALKALOSIS | -tingling of fingers/toes -dizziness -hypertonic muscles **SYMPTOMS OF HYPOCALCEMIA OFTEN PREDOMINANT SYMPTOM OF ALKALOSIS** |
| **SYMPTOMS OF HYPOCALCEMIA OFTEN PREDOMINANT SYMPTOM OF ALKALOSIS** S/S = | -depressed respirations -atrial tachycardia -hypokalemia (as pH increases) -ventricular disturbances occur *ECG= frequent premature U waves* -decreased motility & paralytic ileus |
| Assessment finding of METABOLIC ALKALOSIS | -pH >7.45 -HCO3-= 26 mEq/L -PaCO2 increases -possible HypOKalemia |
| Which test levels may help identify cause of metabolic alkalosis (if pt history inadequate)? | URINE CHLORIDE LEVELS may help identify cause of metabolic alkalosis |
| Urine Cloride concentrations help differentiate between (x), (x), and (x) as cause of metabolic alkalosis | Urine Cloride concentrations help differentiate between VOMITING (<25), DIURETIC THERAPY(<25), and EXCESSIVE ADRENOCORTICOSTEROID SECRETION(>40) as cause of metabolic alkalosis |
| Mgt of alkalosis | -correct cause -monitor I&O -Admin Sodium Chloride(NaCl) fluids **if hypokalemia - admin KCl if gastric suction = Rx: Tagamet |
| pts with heart failure can't tol rapid volume expansion: treat metabolic alkalosis with.. | pts with heart failure can't tol rapid volume expansion: treat metabolic alkalosis with..CARBONIC ANHYDRASE INHIBITORS |
| METABOLIC ALKALOSIS (Ph>7.45) INITIAL EVENT: ↑ ph ↑ HCO3 ↑or normal PaCO2 COMPENSATION = ? | METABOLIC ALKALOSIS (Ph>7.45) COMPENSATION = ? HypOventilation = ↑PaCO2 |
Created by:
rtcdavis
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