What does ROME mean?
- RO: Respiratory Opposite
- Resp Acidosis: ↓ pH ↑ paCO2Resp Alkalosis: ↑ pH ↓ paCO2
- ME: Metabolic Equal
- Met Acidosis: ↓ pH ↓ HCO3-Met Alkalosis: ↑ pH ↑ HCO3-
What can cause Respiratory Acidosis?
- Drug Overdose
- Airway Obstruction
- Pulmonary Edema
- Chest Trauma
What can cause Metabolic Acidosis?
- Renal Failure
- Salicyate Overdose
What can cause Respiratory Alkalosis?
- High Altitudes
- Initial Pulmonary Embolism
What can cause Metabolic Alkalosis?
- Lost Gastric Juices (vomiting)
- Potassium-Wasting Diuretics
- Overuse of Antacids
What are some manifestations of Respiratory Acidosis?
- ↓ pH (↓ 7.35)
- ↑ paCO2 (↑ 45 mmHg)
- Hypoventilation = Hypoxia
- Rapid, Shallow Breaths
- ↓ BP w/vasodilation
- Hyperkalemia w/ Dysrhythmias
- Drowzy, Dizzy, Disoriented, HA
- Muscle Weakness or Hyperreflexia
- Retention of CO2 in lungs
What are some manifestions of Respiratory Alkalosis?
- ↑ pH (↑ 7.45)
- ↓ paCO2 (↓ 35 mmHg)
- Deep, Rapid Breathing
- ↓ BP
- Lethargy, Confusion, Light-Headedness
What are some manifestations of Metabolic Acidosis?
- ↓ pH (↓ 7.35)
- ↓ HCO3 (↓ 22 mEq/L)
- Compensatory Hyperventilation
- ↓ BP
- Change in LOC, Confusion, HA, Drowzy
- Hyperkalemia, Muscle Twitching
- Warm, Flushed Skin
- N/V, Diarrhea
What are some manifestations of Metabolic Alkalosis?
- ↑ pH (↑ 7.45)
- ↑ HCO3 (↑ 26 mEq/L)
- Compensatory Hypoventilation
- Dysrhythmias, Tachycardia
- Dizzy, Confusion, ↓ LOC, Irritability
- N/V, Diarrhea
- Tingling, Tremors, Cramps
Does potassium increase or decrease during acidosis?
Under what conditions should you watch potassium levels?
- Renal Failure
- Hydration Imbalances
- Acid-Base Imbalances
- Cellular Damage (burns, accidents, srgry)
- IV Fluids
What are some signs of Hyperkalemia?
- Muscle: Twitches, Cramps, Paresthesia
- CNS: Irritability, Anxiety
- Heart: ↓ BP, EKG Δ, Dysrhythmia
- GI: Diarrhea, Abd Cramps
What are some s/sx Hypokalemia?
- A: Alkalosis
- S: Shallow Breathing
- I: Irritability
- C: Confusion, Drowsiness
- W: Weakness, Fatigue
- A: Arrhythmias
- L: Lethargy
- T: Thready Pulse
What are the functions of Sodium?
- nerve impulses
- Na/K Pump
- Control/Regulate Body Fluid Volume
- Maintain Water Balance
- Primary Regulator of ECF Volume
Regulation of Sodium?
- maintained in narrow range
- deviations quickly become serious to health
- affected by both salt and water intake
- conserved by reabsorption in kidneys by aldosterone
Primary solvent, medium for transport, facilitates, metabolism and chemical process, maintain temperature, facilitate digestion and elimination, tissue lubricant
Total Body Water Fluid:
- total amount of water in body
- 50-60% body weight
What is Intracellular Fluid?
- ICF: inside the cell
- 35-40% body weight
What is Extracellular Fluid?
- ECF: outside the cell
- 15-20% body weight
- provides nourishment and receives wastes to/from each cell
What is Intravascular Fluid?
- IntraVascular: 5% TBW
- Plasma; liquid component of blood
What is Interstitial Fluid?
- Interstitial: 10-15% TBW
- between cells and tissues
- includes lymph
- Semipermeable membrane: some solutes pass, some don’t
- MAJOR METHOD of transporting body fluid
- Water shifts from low solute concentration to high solute concentration to reach equilibrium
- An increased difference in solute concentrations mean an increased OSMOTIC PRESSURE
What is Diffusion?
- Tendency of solutes to move freely throughout a solution
- Solutes move from area of high concentration to low concentration
- Ex. O2 and CO2 in lungs
What is Active Transport?
- Active Transport “Pump Action”
- Requires ATP energy to pump solutes across membrane from high concentration to low concentration
- Ex. amino acid, some glucose, sodium, chloride, potassium, hydrogen, calcium, magnesium, phosphate
Factilitates passage of fluid through a permeable membrane from area of high concentration to low concentration
Explain the Thirst Mechanism in Homeostasis:
- Regulatory center in hypothalamus
- Triggered in response to low blood volume, intracellular dehydration (ADH hormone)
Explain role of Kidneys in Homeostatis:
- Kidneys: “master chemist”
- Normally filters 180L plasma/day
- Only produces 1.5L urine/day
- Selectively retains or excretes electrolytes and water based on body’s needs
- Regulates pH by excreting H+ ions
- Excretes wastes and toxic substances
Explain the role of the Lungs to maintain Homeostasis:
- Lungs: fast-acting
- ACID-BASE BALANCE
- Regulates 02 and CO2 levels
- Metabolic Alkalosis: lungs hypoventilate to increase CO2 and decrease O2
- Metabolic Acidosis: lungs hyperventilate to decrease CO2 and increase O2
Role of Heart/Blood Vessels in Homeostasis:
- Circulates blood through kidneys to produce urine
- Stimulated fluid retention in Hypovolemia
Role of Parathyroid Gland in Homeostasis:
- PTH regulates calcium and phosphate levels
- REABSORPTION of calcium from [bones, kidneys, sm. int.] and into blood
- Phosphorous from blood enters kidney and excretes in urine
Role of Adrenal Glad in Homeostasis:
- Regulates Blood Volume and Sodium-Potassium balance
- Secretes Aldosterone to retain sodium and excrete potassium
Role of Pituitary Gland in Homeostasis:
- ADH hormone for increased water retention
- Maintain osmotic pressure
- Controls Blood Volume
What are Buffer Systems? Name 3.
- Buffer Systems: prevent body fluids from becoming too acidic or alkalotic
- --Carbonic Acid-Sodium System
- --Phosphate System
- --Protein System
- (short term)
- Primary controller of carbonic acid
- Acidic: increase in CO2 stimulates the medulla to increase rate/depth respiration to decrease carbonic acid and become more alkaline
- Alkolitic: decrease in CO2 stimulates the medulla to decrease rate/depth of respirations to increase carbonic acid and become more acidic
- (takes longer, about 3 days)
- Primary controller of bicarbonate concentration
- Excretes or retains H+ ions and forms or excretes bicarbonate ions in response to pH of blood
- Acidosis: excrete H+, form and conserve bicarbonate
- Alkalosis: retain H+, excrete bicarbonate
- NORMAL pH of URINE: 4.2-8.5
What is a Hypertonic solution?
- [3% saline solution]
- more solutes than own blood
- (solution pulls fluid from body)
What is an Isotonic solution?
- [0.9% saline, most like blood]
- “even”=most like your serum/blood
- (there should not be any substantial difference in the way the blood works)
- for replacement of fluid in your vascular space
What is a Hypotonic Solution?
- [0.3% normal saline or 0.45% 1/2normal saline]
- less solutes than own blood
- (body pulls fluid from solution)
What are s/sx Fluid Deficit?
- Eyes sunken
- Dry mouth: mucous membrane, chapped/ dry lips
- Dry skin
- Decreased skin turgor
- Central cyanosis of tongue, maybe deep furrows
- Weight loss
What is an Acid?
Acid: substance contains hydrogen ions that can be contained or released
What is a Base?
Base: has an affinity for hydrogen ions, traps them