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Acid-Base Balance

Terms in this set (59)

Recap Of Vaccination schedules
MMR and Varicella- Given at 1 yr
Flu- Given at 6 months
Everything else- Given before 6 months
Acids are released into fluid through
Hydrogen ions
Strong Acids release
More hydrogen ions
Weaker Acids release
less hydrogen ions
The higher the concentration of Hydrogen ions in a solution
The more acidic the solution will be
Stomach pH =
4
*Normal Blood pH
7.35-7.45
More hydrogen ions =
More acidic
Acids are produced by
Metabolism
What two major systems control acid-base balance ?
Lungs and Kidneys
Body systems work together to maintain a slightly ________ pH for optimal function
Alkaline
CO2 contains
Carbonic acid
CO2 is measure in blood as
PaCO2
Normal Blood Level of PaCO2 is
35-45mmHG
When Bicarb(base) is low and Carbonic acid is high, the lungs do what?
Lungs blow off more CO2 to excrete the carbonic acid to increase concentration of Bicarb and raise pH
When Carbonic acid is low and Bicarb is high the lungs do what?
The lungs retain CO2 to help increase concentration of acid and lower pH
Shallow Breathing occurs when?
When acid is low. This helps to retain acid and lower pH.
T/F: Respiratory system is the Rapid Response system to acid/base imbalance
True!
Lungs focus on the excretion and conservation of what molecule to help balance acid-base levels.
Lungs excrete and retain CO2 which contain Carbonic acid.
Which system is the slower response to fix acid-base imbalance?
Renal System- acts slow but over long term
The renal system eliminates or retains what molecule to help regulate acid-base balance
Kidneys excrete and retain both hydrogen atoms and bicarb to help regulate acid-base system
WHen Hydrogen Ions are high the kidneys
kidneys excrete hydrogen ions and reabsorb bicarb to help Raise pH
When Hydrogen ions are low the kidneys
retain hydrogen ions and excrete bicarb to make pH lower or more acidic.
Normal Bicarbonate levels are
22-26mEq/L
Buffer system in the body work with the lungs and kidneys to maintain an optimal pH
*
Optimal function follows a ratio of Carbonic acid to bicarbonate of
1 part carbonic Acid to 20 parts bicarbonate; 1:20
Bicarb Buffer system
Strong acids outweighing bicarb= acidosis
Carbonic acid buffer system
Strong bases outweighing carbonic acid= alkalosis
Hypoventilation causes CO2 retention in the lungs which can cause
Respiratory Acidosis
How does the body compensate for Respiratory Acidosis?
The Kidneys will retain bicarb and excrete Hydrogen ions to raise pH and counteract the Resp Acidosis.
What causes Respiratory Acidosis?
Sever Respiratory Diseases that cause lungs to retain CO2 such as: Asthma, COPD, and resp depression from narcotics.
Hypoventilation does what to the pH of blood?
It will lower the pH because CO2 is being retained by the lungs causing a more acidic environment
Hyperventilation will cause which Respiratory pH imbalance?
It will cause Respiratory Alkalosis because too much CO2 is being exhaled so Carbonic Acid is being decreased and pH rises and becomes Alkaline
How does the body compensate for Respiratory Alkalosis!
Kidneys excrete bicarb and retain hydrogen ions to increase Hydrogen ion concentration and make environment more acidic.
What causes Resp Alkalosis?
Hyperventilation r/t: Fever, Respiratory Infection, Anxiety
What is the term used when Bicarbonate in the kidneys is low in relation to Carbonic Acid?
Metabolic Acidosis (More acid than base)
How does the body compensate for Metabolic Acidosis?
Low pH stimulates the lungs to blow off carbonic acid with increase in rate and depth of respirations. This lowers CO2 concentration thus Raising the pH
Kussmaul Respirations
very deep, gasping type of respiration associated with severe diabetic ketoacidosis
What causes Metabolic Acidosis?
Diabetic Ketoacidosis, Prolonged Diarrhea (Body loses Bicarb through Diarrhea)
Diabetic Ketoacidosis is r/t which type of DM?
Type 1 Diabetes
Insulin does what to Glucose in the body?
Pushes it into the cells so it can be used for energy
Ketoacidosis
elevated ketone bodies in blood due to low production of insulin; glucose is not taken in by cells so body uses fat for energy causing high amounts of Ketones in blood.
What to suspect when ketones are in urine?
Suspect that sugar is low- they are dehydrated
How to treat DKA?
Administer D10%W to help raise blood glucose level
What is Metabolic Alkalosis?
When bicrabonate in kidneys is high in relation to carbonic acid
How does the body compensate for Metabolic Alkalosis?
The lungs suppress their effort and less CO2 is exhaled. Retaining CO2 helps to retain carbonic acid and helps lower pH back to normal level.
What causes Metabolic Alkalosis?
Ingestion of excess bicarb, prolonged vomiting which causes a loss of stomach acid
How is Acid-base imbalanced determined?
Through looking at Arterial Blood Gases ABGs
How to interpret what is wrong with patient regarding acid-base imbalance
First get blood pH- is it Low(acidic) or high(alkaline)
2nd: Figure out what caused the imbalance. Is the PaCO2 or HCO3 abnormal?
Then determine whether or not the body is compensating.
I PaCO2 is abnormal where is the problem?
Respiratory system
If the HCO3 is abnormal where is the problem?
Metabolic system (Kidneys)
If both are abnormal
Look to see which is deviated the most
Acid-base imbalance will be compensated for in 3 ways
Uncompensated, Partially Compensated, Fully compensated
Uncompensated
Body has made no attempt to compensate
partially compensated
Body is attempting to compensate but blood pH remains abnormal
Fully Compensated
Body is correcting the imbalance, Blood pH is normal; Other blood gas values will remain abnormal until underlying problem is fixed
What exactly is Compensation?
It is the body's way of restoring normal blood pH
T/F: Compensation helps to treat the root cause of the imbalance.
False! Compensation only helps to manage the acid-base imbalance. The cause of the imbalance is still there and must be corrected.
what does ROME stand for?
Respiratory Opposite Metabolic Equal
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