Acid Base

  1. What does pH measure and what is the normal range of blood pH?
    • Measure of H+ ion concentration
    • Normal range for pH is 7.35 to 7.45
  2. Describe the acid/base regulator Buffers
    • act chemically to neutralize acids or change strong acids to weak acids
    • Primary regulators
    • React immediately
    • Cannot maintain pH without adequate respiratory and renal function
  3. Describe the respiratory acid/base regulator
    • eliminates CO2
    • medulla in the brainstem controls the rate of excretion of CO2
    • Responds within minutes/hours
    • Increased respirations lead to increased CO2 elimination and decreased CO2 in blood (less carbonic acid and less H+)
  4. Describe the Renal acid/base regulator
    • eliminate H+ and reabsorb HCO3−
    • Reabsorption and secretion of electrolytes (e.g., Na+, Cl−)
    • Slower to respond - hours to days
  5. Respiratory Alkalosis presentation, cause, and regulatory action
    • pCO2 is low [< 35 mm Hg]
    • pH is high [>7.4]
    • O2 is normal
    • cause = hyperventilation
    • If condition persists, kidneys will compensate by excreting HCO3
  6. Respiratory Alkalosis S/Sx
    • Pts. Will hyperventilate to compensate for hypoxemia
    • anxiety, apprehension, restlessness
    • lightheadedness, circumoral numbness
  7. Respiratory Alkalosis Interventions
    • Directed at underlying cause
    • Anxiety, hyperventilation, etc.
  8. Respiratory Acidosis presentation, cause, and regulatory action
    • pCO2 is high [>45]
    • pH is low
    • In Chronic Respiratory Acidosis [PCO2 >50]
    • cause = hypoventilation
    • kidneys will compensate by retaining HCO3, given time
  9. Respiratory Acidosis S/Sx
    • depth of ventilation-chest not rising adequately
    • restlessness, apprehension, disorientation [R/T hypoxemia]
    • lethargy “CO2 narcosis”
  10. Respiratory Acidosis Interventions
    • Improve ventilation: elevate HOB, head tilt, etc.
    • Check oxygenation: PO2/Sat from ABG or pulse oximetry
  11. Metabolic Acidosis presentation
    • base bicarbonate deficit
    • HCO3 is low [ < 22-26 mEq/L]
    • pH is low
    • Too much acid: diabetic ketoacidosis, Lactic acidosis/ shock, end stage renal disease
    • Too little HCO3: Loss in severe diharrea, GI fistula
  12. Metabolic Acidosis S/Sx
    • rapid, deep breathing [compensatory mechanism - “blowing off acid”]
    • drowsiness, disorientation
    • hyperkalemia
    • cardiac dysrhythmia
  13. Metabolic Alkalosis presentation and causes
    • base bicarbonate excess
    • HCO3 is high [> 26 mEq /L]
    • pH is high
    • Too much base: excessive antacid use
    • Too little acid: severe vomiting, gastric suction [large amounts], high-dose diuretic therapy
  14. Mixed Acid Base Disorder
    • when two or more disorders are present at the same time
    • Respiratory acidosis combined with metabolic alkalosis may result in a near-normal pH
    • respiratory acidosis combined with metabolic acidosis causes a greater decrease in pH than either disorder alone
  15. Normal serum pH range
    7.34-7.45
  16. Normal PaCO2 range
    35-45
  17. Normal Bircarbonate (HCO3) range
    22-26
  18. Normal PaO2 range
    80-100
  19. *pH 7.58 *PaCO2: 35mmHg *PaO2: 75mmHg *HCO3: 50mEq/L
      a)Respiratory acidosis
      b)Respiratory alkalosis
      c)Metabolic acidosis
      d)Metabolic alkalosis
    d) Metabolic alkalosis
  20. *pH 7.60 *PaCO2: 30mmHg *PaO2: 60mmHg *HCO3: 22mEq/L
    a)Respiratory acidosis
    b)Respiratory alkalosis
    c)Metabolic acidosis
    d)Metabolic alkalosis
    b) Respiratory alkalosis
  21. *pH 7.18 *PaCO2: 38mmHg *PaO2: 70mmHg *HCO3: 15mEq/L
    a)Respiratory acidosis
    b)Respiratory alkalosis
    c)Metabolic acidosis
    d)Metabolic alkalosis
    c) Metabolic acidosis
  22. *pH 7.20 *PaCO2: 58mmHg *PaO2: 59mmHg *HCO3: 24mEq/L
    a)Respiratory acidosis
    b)Respiratory alkalosis
    c)Metabolic acidosis
    d)Metabolic alkalosis
    a) Respiratory acidosis
Author
AubreeA96
ID
346663
Card Set
Acid Base
Description
Acid Base objectives
Updated