Is the main source of acid co 2 production due to

Info icon This preview shows pages 15–28. Sign up to view the full content.

View Full Document Right Arrow Icon
is the main source of acid CO 2 production due to dietary carbohydrate, protein and fat catabolism Tissue metabolism Alkali is introduced through the diet
Image of page 15

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Acid-Base Homeostasis Regulated by: Extracellular Buffering Respiratory Tract Kidneys
Image of page 16
Extracellular Buffering Rapidly responds to changes in H+ concentration Primary extracellular buffering system is carbonic acid/bicarbonate Phosphate and proteins are more abundant intracellularly Cannot effectively maintain homeostasis alone
Image of page 17

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Respiratory Regulation 2nd line of defense Responds within minutes Chemoreceptors in brainstem respond to changes in pCO 2 and pH ∆ rate or depth of ventilation  ∆ CO 2 excretion  ∆ pH CO2 + H2O ↔ H2CO3 ↔ HCO3- + H+
Image of page 18
Renal Regulation Occurs over several days Kidneys regulate acid-base homeostasis by altering: Proximal tubular HCO3- reabsorption Renal ammoniagenesis For each NH4+ that is excreted, one HCO3- is returned to circulation Distal tubular H + excretion For each H+ that is secreted, one bicarbonate ion is returned to circulation
Image of page 19

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Assessing a Patient’s Acid-Base Balance
Image of page 20
Steps in assessing a patient’s acid-base status 1. Collect pertinent labs 2. Answer the following questions: a. Is acidemia or alkalemia present? b. Is the primary abnormality respiratory or metabolic? c. Is there compensation? d. Was the compensatory response appropriate? e. Is there an anion gap?
Image of page 21

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Assessing Acid-Base Status Collect Pertinent Labs: Arterial Blood Gas (ABG) Use arterial blood Reflects degree of oxygenation by lungs Electrolyte panel Use venous blood Reflects oxygen use by tissues
Image of page 22
Assessing Acid-Base Status ABG Oxygenation PaO2 SaO2 Acid-base status pH (directly measured) PaCO2 (directly measured) HCO3- (calculated) Normal ABG Values pH 7.4 (7.35-7.45) PaO 2 80-105 mmHg SaO 2 95% PaCO 2 35-45 mmHg HCO 3 - 22-26 mmHg
Image of page 23

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Assessing Acid-Base Status Electrolytes Compare HCO3- from ABG and electrolyte panel ABG and electrolyte panel should be drawn at approximately the same time Levels should be similar We’ll use this later to calculate an anion gap
Image of page 24
Assessing Acid-Base Status 1. Is acidemia or alkalemia present? Look at pH: is it acidic or basic? pH = 7.3 pH = 7.52 pH = 7.37 pH = 7.11
Image of page 25

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Assessing Acid-Base Status 2. Is the primary abnormality respiratory or metabolic? Look at PaCO2 Identify whether it is acidic, basic or normal 26mmHg 51mmHg Look at HCO3- Identify whether it is acidic, basic or normal 16mmHg 32mmHg
Image of page 26
Assessing Acid-Base Status 2. Is the primary abnormality respiratory or metabolic? If the pH is acidic, identify which parameter (PaCO2 or HCO3-) is also acidic THIS IS YOUR PRIMARY ABNORMALITY!!
Image of page 27

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 28
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern