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ACID/BASE BASICS
| Question | Answer |
|---|---|
| Cabonic Acid = | Carbonic acid = H2CO3 |
| Bicarbonate (base) = | Bicarbonate (base) = HCO3- |
| The ↓serum pH the ↑ or ↓ the H+? | The ↓serum pH the ↑ the H+? |
| The ↑serum pH the ↑ or ↓ the H+? | The ↑serum pH the ↓ the H+? |
| If the blood is ACIDIC the force of cardiac contractions __? | If the blood is ACIDIC the force of cardiac contractions DIMINISHES |
| If the blood is ALKALINIC neuromuscular fxn becomes__? | If the blood is ALKALINIC neuromuscular fxn becomes IMPAIRED |
| A blood pH below__ or above __ is usually fatal | A blood pH below 6.8 or above 7.8 is usually fatal |
| normal RATIO bicarb (HCO3-): carbonic acid (H2CO3)? | normal RATIO 20:1 bicarb (HCO3-): carbonic acid (H2CO3) |
| The 3main blood, ECF & ICF chemical buffers are? | -Bicarbonate (HCO3-) -Phosphate & Protein |
| The lungs regulate serum CO2 Which combines with H2O to form ? | Lungs → CO2 + H2O = H2CO3 (carbonic acid) |
| Normal PaCO2 Partial Pressure ArterialCO2? | Normal PaCO2 35-45 mmHg |
| Normal serum bicarbonate HCO3-? | Normal HCO3- 22-26 mmEq/L |
| When blood is ACIDIC kidneys __HCO3- and __ H+ | When blood is ACIDIC kidneys REABSORB HCO3- and EXCRETE H+ |
| When blood is ALKALINE kidneys __HCO3- and __ H+ | When blood is ALKALINE kidneys EXCRETE HCO3- and RETAIN H+ |
| If imbalance is respiratory which values will be abnormal? | If imbalance is RESPIRATORY PaCO2 (serum CO2) abnormal |
| If imbalance is metabolic which values will be abnormal? | If imbalance is METABOLIC SERUM HCO3- abnormal |
| HYPOVENTILATION causes? | Respiratory ACIDOSIS (retained CO2) |
| Values of Respiratory Acidosis? | pH <7.35 PaCO2 > 45 mmHg HCO3- normal |
| HYPERVENTILATION causes? | Respiratory ALKALOSIS (eliminate too much CO2/anxiety) |
| Values of Respiratory Alkalosis? | pH > 7.45 PaCO2 < 35 mmHg HCO3- normal |
| Metabolic Acidosis values? | HCO3- < 22 mmEq/L pH <7.35 PaCO2 normal |
| Metabolic Alkalosis values? | HCO3- >26mmEq/L pH > 7.45 PaCO2 normal |
| (MEMORIZE) NORMAL ABG VALUES | Ph: 7.35 - 7.45 PaCO2: 35 - 45 mmHg HCO3-: 22 – 26 mmEq/L |
| In RESPIRATORY acid/base imbalance which 2 values move in opposite directions? | pH and PaCO2 |
| In RESPIRATORY acid/base imbalance pH and PaCO2 move in what direction? | In RESPIRATORY acid/base imbalance pH and PaCO2 move OPPOSITE directions |
| In METABOLIC acid/base imbalance what 2 values move in same direction? | pH and HCO3- |
| In METABOLIC acid/base imbalance pH and HCO3- move in what direction? | In METABOLIC acid/base imbalance pH and HCO3- move in SAME direction |
| (MEMORIZE) ABNORMAL ABG VALUES AS ACIDIC / ALKALINE? | Basic < 35 PaCO2 45 > Acidic Acidic < 7.35 pH 7.45 > Basic Acidic < 22 HCO3 26 > Basic |
| process to determine a/b imbalance? | -List and compare pH, PaCO2, HCO3 with normal values. -write A, B or N next to results -circle same letters(A,B,N) -circled pH/PaCO2=respiratory -circled pH/HCO3=metabolic -circled all 3=combined |
| Respiratory ACIDOSIS primary issue? | alveolar hypOventilation |
| Causes of RESP ACIDOSIS | -acute pulmonary edema -CNS depression/oversedation -chronic resp disease -severe resp infection - < mechanical ventilation |
| Respiratory ALKALOSIS primary issue? | alveolar hypERventilation |
| Causes of RESP ALKALOSIS | -anxiety-fear-pain -exercise/heart failure -early sepsis/fever -> mechanical ventilation -hypoxemia/liver failure |
| Metabolic ACIDOSIS primary issue? | > acid (H2CO3) < bicarb (HCO3-) |
| Causes METABOLIC ACIDOSIS > acid causes | -renal failure/ketoacidosis -severe sepsis -anaerobic metabolism -starvation -salicylate intox |
| Causes METABOLIC ACIDOSIS < bicarb (HCO3-) | -anhydrase inhibitors -diarrhea -hypERKalemia -intestinal fistulas |
| Metabolic ALKALOSIS primary issue? | > bicarb (HCO3-) < acid (H2CO3) |
| Causes Metabolic ALKALOSIS > bicarb(HCO3-) | -excessive antacids -excessive bicarb -lactate admin/dialysis |
| Causes Metabolic ALKALOSIS < acid (H2CO3) | -loop thiazide diuretics -steroids -vomiting / NG suction -hypOKalmeia / hypOChloremia |
| Treatment of severe metabolic acidosis? | IV Bicarb (sodium bicarb?) |
| Treatment of metabolic alkalosis? | Replace fluid, sodium, potassium |
| Treatment of respiratory acidosis? | Improve ventilation -bronchodilators -mechanical ventilation |
| Treatment of respiratory alkalosis? | -Slow respiratory rate -Rx anxiolytic -pain relief if indicated -paper bag breathing (haha!) |
Created by:
rtcdavis
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