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