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meta Alkalosis >HCO3

metabolic alkalosis -bicarb excess- acid/base disturbance ch 14 p293-298

QuestionAnswer
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