acid base for test outs
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| what is the ratio of hydrogen ions to bicards | 1:20
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| what is the other term for hydrogen ions; what is the other way to write bicarb | H+; HCO3
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| acidosis: this is increased __; this is decreased ____ | H; bicarb
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| alkalosis: this is an increased ____; this is a decreased _____ | HCO3; H
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| acidosis:what are the primary causes; this can result in what serious thing; | increased k+; coma;
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| acidosis: metabolic- there is an overproduction of ___; there can be an excessive ingestion of ____; there is an inadequate function of what; an abnormal loss of ___ can cause this; | H; H; renal function; alkali losses;
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| acidosis: respiratory- a decreased ___ area in the lungs can cause this; | surface area;
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| anything that decreases resp. rate and depth can cause what imbalance | respiratory acidosis
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| alkalosis: what is t he main serious symptom that it can cause; is it caused by increased or decreased k+; | seizures bc of CNS irritability; decreased;
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| alkalosis: metabolic- there is an excessive loss of ___; there is an excessive ingestion of ___; | H; HCO3
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| alkalosis: respiratory- this is caused by hyperventilation or hypoventilation; this is caused by overstimulation of ___ | hyper- increased resp rate; the CNS
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| compensatory mechanisms: what are the 3; | buffer systems, respiratory control, renal control;
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| compensatory mechanisms: buffer systems- how fast is the response; what does it do; | immediate; it acts like a sponge soaking up or releasing H to maintain pH;
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| compensatory mechanisms: respiratory control- how fast is the response; what does it do; | w/in minutes to hours; it changes CO2 content in blood by changing resp. rate and depth
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| compensatory mechanisms: renal control- when does it respond; what does it do; | hours to days; it saves or excrete HCO3 or H
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| compensatory mechanisms: if cause of imbalance is resp what steps in to compensate; if the cause of imbalance is metabolic what steps in to compensate; how long does it take for the kidneys to compensate; how long does it take for the lungs to compensate | kidneys; lungs; a while; quickly
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| compensatory mechanisms: will the body over compensate; can there be more then one cause of acid base imbalance | no; yes
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| ABG lab norms: what is norm . .. pH; PCO2; PO2; HCO3; O2 sat; BE; | 7.35-7.45; 35-45; 80-100; 23-27; 96-100%; -2 - 2+
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| Acidosis: this is an abnormal gain of ___; this is an abnormal loss of ___; what is the primary s/s; the primary s/s is caused by what; why is there increased K+ in the vascular space; CNS depression can cause what | H2; HCO3; CNS depression; increased K+ in the vascular space; K+ moves out of the cell and and H+ moves into the cell; a coma
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| Alkalosis: there is an abnormal gain of ___; there is an abnormal loss of ____; what are the primary s/s r/t; CNS irritability can cause what; what causes CNS irratibility; how does hypocalcemia cause seizures; | HCO3; H+; CNS irritability; seizures; hypocalcemia; b/c there are low levels of Ca in serum
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| in metabolic what is affected; in respiratory what is affected; what compensates in metabolic; what compensates in respiratory | kidneys; lungs; lungs; kidneys
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| metabolic acidosis: there is an overproduction of ____; what dx can cause an overproduction of h+; caused by an excessive ingestion of ___; | H+; DM, starvation, fever, lactic acidosis, anesthesia, severe infection; H+
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| metabolic acidosis: what is an example of excessive ingestion of H+; in this what organ dysfuntion can cause this; | ketogenic diets, Aspirin ingestion; inadequate renal function;
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| metabolic acidosis: inadequate renal function- what is not excreted like it should be; what is not absorbed like it should be; | H+; HCO3-
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| metabolic acidosis: this can be caused by an abnormal loss of ___; examples of HCO3- loss; | HCO3-; intestinal fistulas or suctioning
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| is H+ acidic or alkali; is HCO3- acid or alkali; | acidic; alkali
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| metabolic acidosis: what is the compensatory organ; what do longs do to compensate; what is increased resp rate and depth trying to get rid of; how long does it take for the lungs to compensate | lungs; they increase resp rate and depth; CO2; min to hours
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| metabolic acidosis: nursing interventions- what IV solution should be given; what med should be given IV; why should there be safety measures; what should be monitored; what labs should be monitored | Ringers lactate; NaHCO3; r/t decreased LOC; I&O, VS; K+
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| Respiratory Acidosis: this can be caused by anything that decreases ___; what organ is effected; if there is a decreased surface area in the lungs there is a decreased____; causes or decreased surface area of the lungs; | resp. rate or rhythm; lungs; diffusion or O2 and CO2; perfusion defects, PNA, atelectasis, CHF;
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| Respiratory Acidosis: how does obstruction cause this; examples of obstruction; what are examples of decreased resp; is there too much H+ or HCO3-; | this prevents the exchange of gases; COPD, bronchitis, asthma; resp center depression, drugs, tumors, immobility, decreased LOC; H+
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| Respiratory Acidosis: what organ tries to compensate to help imbalance; what do the Kidneys excrete; what does the kidneys save; how long does it take for the kidneys to compensate; what organ is affected | kidneys; H+; HCO3; hours to days; lungs
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| Respiratory Acidosis: nursing interventions- what should be treated; should ventilation increase or decrease; what are interventions to improve ventilation; why are safety measures needed | underlying problem; increase; turn, C&DB, elevate HOB, ventilator; b/c or decreased LOC
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| metabolic acidosis: there is an excessive loss of ___; what are examples of excessive loss or H+; this can be caused by an excessive ingestion of ____; what is an example of excessive ingestion of HCO3+ | H+; simple vomiting,gastric suctioning, K+ loss, fistulas, mineral corticoids, diretics; HCO3-; antacids
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| metabolic acidosis: what organ is affected; what in body tries to compensate; does lungs increase or decrease resp rate and depth; does it try to hang onto or get rib of CO2; how long does it take for the lungs to respond | kidneys; lungs; decrease; hang onto it; min to hours
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| metabolic acidosis: nursing interventions- what should be treated; what labs should be treated; what med to give; what precautions should be made; | underlying cause; hypochloremia, hypokalemia; Ca gluconate; seizure precautions;
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| respiratory alkalosis: there can be an overstimulation of ____ center; what could cause the overstimulation of the resp center; can hyper or hypo ventilation cause this; what could cause hyperventilation; | the resp center; fever, CNS disease, ASA poisoning, intracranial surgery; hyerpventilation; anxiety, pain, poor vent settings;
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| respiratory alkalosis: what organ is effected; what organ tries to compensate; the kidneys try to excrete ___; the kidneys try to save ____; how long does it take for kidneys to compensate; is it trying to keep acid or alkali; | lungs; the kidneys; HCO3-; H+; hours-days; acid
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| respiratory alkalosis: nursing interventions- what is treatment goal; what mask should be used; what labs need to be treated; what med should be given; why do safety measures need to be in place; | underlying cause; rebreather mask; hypokalemia, hypochloremia; Ca gluconate; risk for seizures
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| Antacid therapy: what is possible imbalance; what is rationale for imbalance; treatment; | metabolic acidosis; this is an antacid so it has bicard- pt could have ingested too much bicarb; treat the cause- need more acid, treat hypochloremia, seizure procautions, give Ca gluconate
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| Anxiety: what is possible imbalance; what is rationale for imbalance; treatment; | Resp Alkalosis; anxiety can cause hyperventilation, hyperventilation can cause too much HCO3 and not enough H+; underlying cause, resp rate and depth needs to be slowed down, o2 rebreather mask, give Ca gluconate, seizure precautions
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| atelectasis: what is possible imbalance; what is rationale for imbalance; treatment; | resp acidosis; there is a decreased surface area in the lungs causes a decrease in diffusion of gas exchange so there is too much acid not enough bicarb; improve ventilation-elavete HOB, O2, cough and DB, safety measures due to dec LOC
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| Chronic Bronchitis: what is possible imbalance; what is rationale for imbalance; treatment; | resp acidosis; there is obstruction in alveoli and there is not enough gas exchange taking place causing too much acid (H+) not enough alkali; treat problem, nebs, c and DB, O2, safety measures;
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| Diarrhea: what is possible imbalance; what is rationale for imbalance; treatment; | metabolic acidosis; the bowel is a very alkali environment and diarrhea can cause an excessive loss HCO3; restore fluids, monitor I&O, VS and potassium levels, at risk for coma
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| loop diuretics: what is possible imbalance; what is rationale for imbalance; treatment; | metabolic alkalosis; there is and excessive loss of H+ b/c as potassium leaves the cell with H20, H+ enters the cell creating a alkaline environement- the H+ is trying to balance out the cations in the cell; restore potassium levels seizure precautions
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| DKA: what is possible imbalance; what is rationale for imbalance; treatment; | metabolic acidosis; the body starts to eat fats b/c the cells are starving w/o insulin the biproducts of fats are ketones which are acids causing an acidic environment; give insulin normal saline, monitor for coma
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| fever: what is possible imbalance; what is rationale for imbalance; treatment; | resp alkalosis or metabolic acidosis; met acid- and the resp alk- b/c fever increases resp rate hypeventilation; treat the fever
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| hyperkalemia: what is possible imbalance; what is rationale for imbalance; treatment; | metabolic acidosis; potassium is released in the cells and found in the blood..itis trying to balance out the cations; treat the cause
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| immobility: what is possible imbalance; what is rationale for imbalance; treatment; | respiratory acidosis; this decreases respiration- mainly depth of resp causing resp acid; move pt 02
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| NG suctioning: what is possible imbalance; what is rationale for imbalance; treatment; | metabolic alkalosis; this removes the natural aids in the gut,causing too much alkali environment;
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| PNA: what is possible imbalance; what is rationale for imbalance; treatment; | resp acidosis; there is a decreased surface area in the lungs not enough gas exchange too much CO2; treat problem, safety measures
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| PE: what is possible imbalance; what is rationale for imbalance; treatment; | resp acidosis; obstruction- not enough gas exchange; treat prob
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| vomiting simple: what is possible imbalance; what is rationale for imbalance; treatment; | metabolic alkalosis; losing acids from stomach too much bicarb; treat vomiting
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| vomiting complex: what is possible imbalance; what is rationale for imbalance; treatment; | metabolic acidosis; we are losing too much bicarb b/c it is prolonged now
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| interpreting ABGS: what value should be looked at 1st; what value 2nd; what value third; what value 4th | PO2; pH; PCO2; HCO3
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| interpreting ABGS: what is perfect pH; what is compensated pH; what is uncompensated pH; | 7.4; with in range of 7.35-7.45; out of the range;
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| interpreting ABGS: what value is the "respitory" value; what value is the "metabolic" value | pCO2; HCO3
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| interpreting ABGS: pCO2- what is range; if it is <35 is it alk or acid; if it is more than 45 is it alk or acid; pCO2 measures what; | 35-45; alk; acid; acids- so elevated levels are acidic
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| interpreting ABGS: HCO3- what is range; <23 is acidic or alkaline; >27 is acid or alkaline; what does HCO3 measure; are bicarbs acidic or alkaline; | 23-27; acidic; alkaline; bicarbs; alkaline- so elevated levels >27 is alkaline
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| hyperventilation: we "blow off" what; this causes what | CO2- acid; alkalosis
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| hypoventilation: with decreased resp rate we retain what; this causes what | CO2; acidosis
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| renal system: they get rid of what; | nonvolatile H+
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| renal system: acidosis- what do the kidneys retain to compensate; what do they excrete; | HCO3; H+
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| renal system: alkalosis- what do kidneys retain to compensate, what do they excrete | H+'; HCO3
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| resp acidosis: what is pH; what is CO2; | <7.4; >45
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| resp alkalosis: what is pH; what is Co2 | >7.4; <35
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| metabolic acidosis: what is pH; what is HCO3 | <7.4; <23
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| metabolic acidosis: what is pH; what is HCO3 | >7.4; >27
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| decreased pH with decreased HCO3 is what | acidosis
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| increased pH with increased HCO3 | alkalosis
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| decreased pH with increased CO2 is what | acidosis
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| increased pH with decreased CO2 is what | alkalosis
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| PO2: this tells what; whatis it hypoxemia; | is pt has hypoxemia; decreased O2 in blood;
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| Sa02: this measures what; this tells whether the patient has what; def hypoxia | the percent of oxygen bound to hemoglobin; hypoxia; decreased O2 in the tissues
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| Base Excess: this is the amount of base needed to return ___to a normal value; | pH;
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| tidal volume def; def expiratory reserve volume; def residual volume; def inspiratory reserve volume; | volume of air inhaled and exhaled with each breath; additional air that can be forcefully exhaled after normal exhalation is complete; amount of air remaining in the lungs after forced expiration; max volume of air that can be inhaled forcefully post inha
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| def total lung capacity; | max volume of air that lungs can contain;
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