CH 27 Summary of Acidosis and Alkalosis

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CH. 27 - FLUID, ELECTROLYTE, AND ACID-BASE HOMEOSTASIS

Acidosis

is a systemic arterial blood pH below 7.35

Acidosis

principal effect is depression of the central nervous system (CNS); depression of the nervous system is so severe that the individual becomes disoriented, then comatose, and may die

alkalosis

is a systemic arterial blood pH above 7.45

alkalosis

its principal effect is overexcitability of the CNS; nervousness, muscle spasms, and even convulsions and death

compensation

physiological response to an acid-base imbalance that acts to normalize arterial blood pH

complete compensation

physiological response to an acid-base imbalance that acts to normalize arterial blood pH

partial compensation

if systemic arterial blood pH is still lower than 7.35 or higher than 7.45

respiratory compensation

hyperventilation or hypoventilation can help bring blood pH back toward the normal range; occurs within minutes and reaches its maximum within hours

renal compensation

changes in secretion of H and reabsorption of HCO3 by the kidney tubules; may begin in minutes, but it takes days to reach maximum effectiveness

respiratory acidosis

Increased Pco2 (above 45 mmHg) and decreased pH (below 7.35) if there is not compensation

respiratory acidosis

caused by hypoventilation due to emphysema, pulmonary edema, trauma to respiratory center, airway obstruction, or dysfunction of muscles of respiration

respiratory acidosis

compensate by renal mechanism: increased excretion of H+; increased reabsorption of HCO3-. If compensation complete, pH will be within the normal range, but Pco2 will be high.

respiratory alkalosis

is decreased Pco2 (below 35 mm Hg) and increased pH (above 7.45) if there is no compensation

respiratory alkalosis

caused by hyperventilation due to oxygen deficiency, pulmonary disease, cerebrovascular accident (CVA), or severe anxiety

respiratory alkalosis

Is compensated by renal mechanism: decreased excretion of H+; decreased reabsorption of HCO3-. If compensation is complete, pH will be within the n ormal range, but PCO2 will be low.

metabolic acidosis

Is decreased HCO3- (below 22 mEq/liter) and decreased pH (below 7.35) if there is no compensation.

metabolic acidosis

Caused by loss of bicarbonate ions due to diarrhea, accumulation of acid (ketosis), renal dysfunction

metabolic acidosis

Compensated by respiratory mechanism: hyperventilation, which increases loss of CO2. If compensation is complete, pH will be within the normal range, but HCO3- will be low.

metabolic alkalosis

Is increased HCO3- (above 26 mEq/liter) and increased pH (above 7.45) if there is no compensation.

metabolic alkalosis

Loss of acid due to vomiting, gastric suctioning, or use of certain diuretics; excessive intake of alkaline drugs.

metabolic alkalosis

Compensated by respiratory mechanism: hypoventilation, which slows loss of CO2. If compensation is complete, pH will bei within the normal range but HCO3- will be high.

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