Unit 8 Acid-Base Balance

Body fluids must maintain an ___________ balance to sustain health, homeostasis, and life

Conditions such as infection or trauma may alter this
delicate ______________

Unit of measure to describe acid-base balance is

pH of water is

Blood pH is

The ____________ of pH is achieved through 3 regulators: —chemical buffer system, —Respiratory system, —Renal system

Acid-base ____________ occur when the carbonic acid (acid) or bicarbonate (base) levels become disproportionate

-—Metabolic acidosis
-—Metabolic alkalosis
-—Respiratory acidosis
-—Respiratory alkalosis

—Cause by ___________________; Chronic obstructive pulmonary disease (COPD),
—Hyperventilation, —Renal failure, —Prolonged use of
antacids/vomiting

pH <7.35

pH >7.45

Normal pH

<7.35 =

>7.45 =

Normal PaC02: _________ mm Hg

Normal HCO3: ________ mEq/L

Excess carbonic acid in ECF; Low pH (7.35), High PaCO2 (>45)

Causes: —Hypoventilation-COPD, narcotics, paralysis

Respiratory rate increases to blow off CO2 (acid)

Kidneys will excrete hydrogen (acid) and conserve bicarb (base)

Deficit of carbonic acid in ECF; High pH (>7.45), Low PaCO2 (<35)

Causes: —Hyperventilation-fever, pain, fear/anxiety, ventilator rate too fast

Body is stimulated to breathe slower and more shallow

Kidneys will increase bicarb (base) excretion and
retain more hydrogen (acid)

Deficit of bicarbonate in ECF; Low pH (<7.35), Low bicarb (<22

Causes: —Increased acid or excessive loss of bicarb (base), —Renal failure, —Overdose of ASA (aspirin)

Lungs attempt to increase CO2 excretion by increasing rate and depth of respirations

Kidneys attempt to compensate by retaining bicarb and excreting more hydrogen (acid)

Excess bicarb or deficit of hydrogen or both; High pH (>7.45), High bicarb (>26)

Causes: —Loss of acids (vomiting/diarrhea), —Ingestion of base (antacids)

1. Slowed breathing (retain CO2- acid), 2. kidneys excrete bicarb (base) and retain hydrogen (acid)

Complete blood count

Basic/complete metabolic panel

—May be more accurate at detecting fluid imbalances

____________ — patient at same time every day, same scale, same type of clothes

—1 kg (gain or loss) =

—Normal pH: 4.6-8.2

—Normal specific gravity: 1.005- 1.030

can cause severe diarrhea

NEVER give IV ___________ fast

does not force fluid in or out of the cells

Contain fluids and electrolytes normally found in the
body

Used as a maintenance fluid to compensate for mild fluid losses

Require large volumes to be effective (multiple liters)

Can result in edema when given in large doses

-Treat hypovolemia
-Fluid replacement with a little sugar

-Temporary
-With blood products

-Treat hypovolemia
-Provides electrolytes

-—5% dextrose in water (D5W or D5)
-—0.9%NaCl (Normal saline or NS)
-—Lactated Ringer’s (LR)

-—Water is pulled into cells by osmosis
-—Can worsen hypotension

Fluid replacement with kidney problems

-Treat hypernatremia

- —Pull water from cells back into circulation
- Correct electrolyte imbalances
- —Resuscitation- suppresses inflammation

Treat hypovolemia

Peripheral parenteral nutrition (PPN)

Treat hypovolemia

Treatment or prevention of potassium depletion in
patients whenever dietary measures are inadequate

Adverse effects: —GI with oral administration- N/V/D, GI bleed (GIB), pain at injection site for IV administration, cardiac arrest if given too rapidly