A&P - Acid Base Balance Flashcards

Terms Definitions
Magnesium =
Arterial oxygen saturation
Respiratory acidosis cause
retained CO2
Thiazide diuretics
hydrochlorothiazide (Esidrix, HydroDIURIL)chlorothiazide (Diuril)trichlormethiazide (Metahydrin)
PCO3: 20
partially compensated respiratory alkalosis; hyperventilation or pain
More water than electrolytes Pure water lyses RBCs Water moves from ECF to ICF by osmosisUsually maintenance fluids
the dissolved substance in a solution
Respiratory alkalosis effect on ABGs
increase pH
Normal pH of blood
7.35 to 7.45
Loop Diuretics Effects
Potassium and sodium depletion
High serum Mg caused byIncreased intake or ingestion of products containing magnesium when renal insufficiency or failure is present
excessive amounts of sodium in the blood
particles are mixed together and not dissolved, particles are relatively large and are permanently suspend (whipped cream)
fluid volume excess
increases interstitial and vascular volumes, hypertension; tachycardia; strong bounding pulses; moist crackles/wheezes; jugular vein distension; dependent edema; taut skin turgor; low or normal urine output; low urine specific gravity; weight gain
The normal range for HCO3 is
22-26 mmHg
clinical manisfestations of metabolic alkalosis
belligerence, irritable, disorientated, lethargy, shallow slow respirations, periods of apnea, tachycardia, dysrhythmias, n/v, hypertonic muscles, tingling of fingers and toes, seizures
Responsible for long term changes to pH
Respiratory Alkalosis Compensation
Decreased respiratory rate; Increased H+ excretion and HCO3 retention by kidneysK+ moves out
metabolic accidosis
The lab reports the following ABG result for your pt. of pH 7.33;PaCO2 40mmHg; and HCO3-, 20mEq/L.You interpret these results as
an excess of chloride in the blood plasma
What are normal PCO2 levels?
PCO2 --> 35-45 mmHg
Metabolic acidosis compensation
rate and depth of respirations increase, eliminating additional CO2
Respiratory Acidosis Compensation
Renal system retains HCO3 and increases secretion of H+
Accounts for more than 90% of the circulating cations in the body
Treatment for Respiratory Acidosis
Maintain patent airway, suction client, administer oxygen
hydrostatic pressure
Pressure exerted by a volume of fluid against a wall, membrane, or some other structure that encloses the fluid.
if the ratio of the henderson-hasselbach equation = 20...
then pH is 7.4
Nursing Interventions for Metabolic Alkalosis

Prevent emesis and decrease gastric suction to reduce the base
Administer 0.9% NSS to replace Na+ loss, K+ supplements, and Diamox to enhance HCO3 excretion
Interpret the ABG: ph 7.50, pCo2 28, HCO3 24, pO2 70
Respiratory Alkalosis
When salt is absorbed by intestinal cells, two transporters are used. What are these transporters and what is produced outside of the cell as a result of their action?
*Na+/H+ antiporter
*Cl-/HCO3- antiporter
*CO2 and water produced outside of cell
If blood has more base and less acid ph is ….?
how do lungs fix metabolic alkalosis?
decrease ventilation- retain CO2 decrease pH back to normal
What is the basic problem in respiratory alkalosis?
Hyperventilation leads to hyperexcretion of CO2. Low PaCO2 equates to low H+ and thus a high pH.
if pH is abnormal and both CO2 and HCO3 are abnormal, what is the compensation level?
partially compensated
Metabolic Alkalosis
Nursing Care
1. Maintain accurate I/O
2. Evaluate labs for decrease in K+
3. Admin Acetazolamide (Diamox) - To increase excretion of HCO3-
What does the anion gap measure?
Extracellular anions not usually measured in ABG like sulfates, phosphates, proteins, Lactic acid and ketone acid.
fluid volume deficit
FVD, when you lose more water than you take in. electrolytes are lost in the same proportion
3rd step to blood gas interpretation
look at metabolic component to determine if imbalance is due to a metabolic reason
Metabolic Alkalosis
Blood Gas Values
1. pH > 7.45
2. PaCO2 normal
3. HCO3- > 26
Represents the respiratory component of the body's acid-base balance
PaC02 = partial pressure of carbon dioxide in arterial blood
What is a nonvolatile organic acid? Give 2 examples.
acids that are intermediates in metabolic pathways (normally metabolize rapidly)- ex. Lactic Acid (anaerobic metabolism) Ketone Bodies (starvation)
How do metabolic systems compensate for a respiratory alkalosis?
Renal excretion of HCO3- is increased; PCO2 remains abnormally low, but pH decreases.
the excess H+ in the carbon dioxide/bicarbonate buffering system does what?
combines with HCO3 to become H2CO3 which quickly dissociates into CO2 + H2O
What creates metabolic acidosis? Alkalosis?
Acidosis is due to the addition of a fixed acid to the blood or removal of a base. Alkalosis is due to the addition of a fixed base to the blood or the loss of an acid.
a metabolic problem is fixed by the ____ and a respiratory problem is fixed by the _____.
metabolic problem by the lungs, and respiratory problem fixed by kidneys
The patient with an acid-base imbalance is partially compensated if _
the pH is outside the normal range and all other values are abnormal
What organ controls the level of PCO2 in the blood? What organ controls [HCO3-] in the blood?
PCO2 is controlled by the lungs, by increases or decreases in ventilation. [HCO3-] is controlled by the kidneys, by increasing or decreasing excretion.
How does the protein buffer system respond to an acid or base?
- if an acid is added, the pH level drops and carboxylate ion and amino group can accept H+- if base is added, the pH rises and the carboxyl group dissociates releasing H+
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