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52 terms

Fund Book: Chapter 26 Notes

Notes on Acid-Base Balance/ fluids and electrolytes need to be added later
pH of fluid
refers to the hydrogen ion concentration of that fluid
Body fluids are maintained at a slightly ___________ level.
Chemical buffer system
act like sponges and combine with acid or alkali to prevent excessive changes in the hydrogen ion concentration.
Respiratory system
The lungs effectively regulate the blood levels of CO₂. CO₂ combines with H₂O to form carbonic acid. Increased levels of CO₂ decrease the pH level. Receptors in the brain identify ph changes and vary the rate and depth of breathing to compensate. Faster, deeper respirations reduce the CO₂ level in the lungs. The decrease in CO₂ increases the pH level. Respiratory response is rapid but short lived.
Renal system
The kidneys reabsorb or excrete acids and bases into the urine. They can produce bicarbonate to refill lost stores. The kidneys have a slower response, but long-term effects result.
Neutralize excess acids or bases, preventing marked changes in hydrogen ion concentration.
Body's first line of defense against acid-base balance changes in they body.
Help regulate acid-base balance by elminating or retaing carbon dioxide, a potential acid.
carbonic acid
This is formed when carbon dioxide combines with water
carbonic acid
This breaks down into carbon dioxide and water.
rate and depth of respirations
The lungs regulate acid-base balance and pH by altering these.
The response of the respiratory system to changes in pH is rapid, and occuring within _______.
carbonic acid and carbon dioxide
When blood levels of these rise, respiratory center stimulation causes the rate and depth of respirations to increase.
bicarbonate levels
When these levels are excessive, the rate and depth of respirations are reduced in order to retain carbon dioxide.
provide primary long-term regulation of acid-base balance and is more permanant and selective.
excess hydrogen ions
When ___________________ are present and the pH falls (acidosis), the kidneys reabsorb and regenerate bicarbonate and excrete hydrogen ions.
raise and reduce
During acidosis, the kidneys reabsorb and regenerate bicarbonate and excrete hydrogen ions, helping to _____ pH and _____ the amount of available acid.
excess bicarbonate
When there is excess bicarbonate and a high pH (alkalosis), the kidneys excrete bicarbonate and retain hydrogen ions.
lower pH and make more acid available
The kidneys excrete bicarbonate and retain hydrogen ions in order to ________ and ___________ to offset the bicarbonate.
regulation of hydrogen ion concentration
The key to acid-base balance is ____________ of body fluids.
respiratory acidosis and alkalosis
One type of acid-base imblances which is a carbonic acid deficit and excess.
Metabolic acidosis and alkalosis
One type of acid-base imblances which is a base bicarbonate deficit and excess.
fully compensated
pH normal with abnormal CO₂ and HCO₂
partially compensated
All values abnormal
Two abnormal values and one normal value
CO₂measured in arterial blood
In (R)espiratory imbalances, the ph and CO₂ (O)pposite (ph ↓ and CO₂ ↑ = acidosis) (ph ↑ and CO₂ ↓ = alkalosis)
In (M)etabolic imbalances, the pH and HCO₃ are "(E)qual" (ph ↓ and HCO₃↓= acidosis)(ph ↑ and HCO₃↑ = alkalosis)
Respiratory acidosis
As carbon dioxide is retained, it creates carbonic acid that builds up in the blood; the pH drops and creates this. A drop in blood pH from carbonic acid buildup.
Respiratory Alkalosis
A client is in a lot of pain and breathing rapidly. The nurse recognizes this will cause CO₂ to be exhaled and the client may develop wich acid-base imbalance?
Metabolic acidosis
A client is admitted with diabetic ketoacidosis (DKA). Due to the ketone bodies formed, the client is most likely experiencing what type acid-base imbalance?
dizziness, tingling of fingers and toes, decreased respirations, and cardiac dysrhythmias
Signs and symptoms that would indicate metabolic alkalosis (bicarbonate excess)
Kussmaul respirations
deep and rapid respirations (hyperventalations) that accompany metabolic acidosis
Metabolic acidosis etiology
diarrhea, diabetic ketoacidosis, renal failure, acid ingestion, fistulas
metabolic alkalosis etiology
gastric suctioning, vomiting, hypokalemia, potassium-losing diuretics, excessive alkali ingestion
respiratory acidosis etiology
aspiration, cardiac arrest, severe pneumonia, emphysema, pulmonary edema, pneumothorax
respiratory alkalosis etilogy
jyperventilation, anxiety, hypoxemia, high fever, pulmonary emboli
metabolic acidosis manifestations
nausea/vomiting, Kussmaul breathing, headache, drowsiness, increades breathing
metabolic acidosis treatment
reverse underlying cause, administer sodium bicarbonate per physician order
metabolic alkalosis manifestations
dizziness, tingling of the fingers, carpopedal spasm, depressed respirations, circumoral paresthesis
metabolic alkalosis treatment
reverse underlying cause, administer chloride for the kidneys to excrete bicarbonate, restore normal fluid volume
respiratory acidosis manifestations
dizziness, palpitations, convulsions, weakness, mental changes, ventricular fibrillation
respiratory acidosis treatment
improve ventilation, use bronchodilators, administer oxygen and fluids.
respiratory alkalosis manifestations
light-headedness, numbness and tingling of extremities, tinnitus, palpitations, blurred vision, chest tightness
respiratory alkalosis treatment
treat source of anxiety, ask client to breathe slowly into a paper bag, administer sedatives as ordered.
Respiratory alkalosis
May develop when hyperventilation occurs. An elevated pH due to a decrease in CO₂(PaCO₂)
Metabolic acidosis
Occurs when bicarbonate is lost or acid is increased within the plasma. Greater than normal acid within the plasma.
Metabolic alkalosis
Occurs when the plasma loses hydrogen ions (acid) and gains bicarbonate. Less than normal acid within the plasma.
Respiratory acidosis mode of compensation
Kidneys will retain increased amounts of HCO₃to increase pH
Respiratory alkalosis mode of compensation
Kidneys will excrete increased amounts of HCO₃to lower pH
Metabolic acidosis mode of compensation
Lungs "blow off" CO₂to raise pH
Metabolic alkalosis mode of compensation
Lungs retain CO₂to lower pH