HCT Med-Surg Acid/Base imbalance
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| Normal pH blood | 7.35 - 7.45
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| Intracellular fluid | K (potassium) 65%
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| Extracellular fluid | 35% (9% intravascular, 26% interstitial)
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| Normal Na range | 135 - 145 mEq/L
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| Hyponatremia | <135 mEq/L
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| Hypernatremia | >145 mEq/L
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| Normal K (potassium) | 3.5 - 5.0 mEq/L
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| Hypokalemia | <3.5 mEq/L
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| Hyperkalemia | >5.0 mEq/L
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| Normal serum Ca (calcium) | 4.5 - 5.6 mEq/L
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| Normal total Ca (calcium) | 9.0 - 10.5 mg/dL
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| Ca is split between serum and total? | 50/50
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| 50% of Ca is bound to | protein
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| Hypocalcemia | <9.0 mg/dL (total) <4.5 (serum) mEq/L
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| Hypercalcemia | >10.5 mg/dL (total) >5.6 mEq/L (serum)
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| Ca requires | Vitamin D for absorption
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| Ca plays a role in | blood clotting, muscle function, nerve impulse tran & cell membrane permeability
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| Na regulates | fluid balance through osmotic pressure
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| K is major electrolyte in | intracellular fluid
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| Na is major electrolyte in | extracellular fluid
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| Na stimulates | conduction of nerve impulses & helps maintain neuromuscular activity
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| Mg+ (magnesium) normal range | 1.5 - 2.5 mEq/L
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| Hypomagnesemia | <1.5 mEq/L (most commonly chronic alcoholism)
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| Hypermagnesemia | >2.5 mEq/L (uncontrolled diabetes, ketoacidosis), antacids
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| PO4 (phosphate) normal range | 1.7 - 2.6 mEq/L
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| Hypophosphatemia | <1.7 mEq/L (most commonly respitory alkalosis, intense prolonged hyperventilation)
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| Hyperphosphatemia | >2.6 mEq/L (most commonly renal failure)
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| Cl (chloride) normal range | 95 - 106 mEq/L
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| Hypochloremia | <95 mEq/L (most commonly vomiting, gastric suction, gastric surg)
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| Hyperchloremia | >106 mEq/L (dehydration)
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| Buffer | attempt to maintain normal pH range.
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| Osmosis | diffusion of water higher to lower concentration
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| Filtration | dissolved substances forced through cell membranes by hydrostatic pressure
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| Diffusion | molecules, gases, liquids or solids from higher to lower concentration
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| Hypotonic solution | cells swell
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| hypertonic solution | cells shrink
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| Isotonic solution | cells do not change
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| Skin fluid loss | insensible 300 - 400 mL/day same as lungs
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| Total fluid loss/day | 2,500 mL/day
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| Lung fluid loss | insensible 300 - 400 mL/day same as skin
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| GI tract | 200 mL/day in feces
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| Kidney fluid loss | 1,200 - 1,500 mL/day
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| Kidney's play a major role | in maintaining fluid balance
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| ADH (antidiuretic hormone) | posterior pituitary gland reabsorb water
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| Aldosterone | adrenal cortex reabsorption of Na
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| PCO2 or PaCO2 | carbon dioxide (partial pressure of)
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| HCO3 | bicarbonate
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| PCO2 normal range | 35 - 45 mmHg at sea level
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| Respitory acidosis | decreased blood pH, increased CO2
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| Respitory alkalosis | increased blood pH, decreased CO2
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| Metabolic acidosis | decreased blood pH, HCO3 & CO2
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| Metabolic alkalosis | increased blood pH, HCO3 & CO2
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| Most common indicator of fluid volume deficiency | thirst
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| Normal HCO3 (bicarbonate) | 24-28 mEq/L
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| Normal BUN (blood urea nitrogen | 5-25 mg/dL
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| Normal Creatinine | 0.5 - 1.5 mg/dL
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| Normal Protein | 6.0 - 8.0 g/dL
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| Normal albumin | 3.5 - 5 g/dL
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| Blood < 7.35 | acidosis
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| Blood > 7.45 | alkalosis
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| PCO2 > 45 | respiratory acidosis
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| PCO2 < 35 | respiratory alkalosis
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| HCO3 > 26 | metabolic alkalosis
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| HCO3 < 22 | metabolic acidosis
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| COPD | Resp. acidosis
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| sedative or barb. OD | Resp. acidosis
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| pneumonia | Resp. acidosis
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| Atalectasis | Resp. acidosis
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| Resp. acidosis | incr. resp, hypotension, weak & thready pulse, tachycardia, warm/flushed skin, h/a, decreased LOC, drowsiness
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| Hyperventilation | Resp. alkalosis
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| Hypoxia | Resp. alkalosis
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| Fear, fever, pain | Resp. alkalosis
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| exercise, anxiety over vent | Resp. alkalosis
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| Diabetic Ketoacidosis | Metabolic acidosis
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| Lactic acidosis | Metabolic acidosis
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| Starvation | Metabolic acidosis
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| Severe diarrhea | Metabolic acidosis
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| Shock | Metabolic acidosis
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| Severe vomiting | Metabolic alkalosis
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| Excessive NG suctioning | Metabolic alkalosis
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| Diuretic therapy | Metabolic alkalosis
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| Metabolic alkalosis | increased heart rate, hypotension, atrial tachcardia, dizziness, respiratory failure, irrability, confusion, tetany, muscle cramps, seizures
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| Metabolic acidosis | Hypotension, cold clammy skin, dysrhythmias, kussmaul's , drowsiness, h/a, confusion, N&V
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| Resp. alkalosis | increased heart rate, syspnea, chest tightness, tetany, seizures, anxiety, panic
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