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Acid Base (Part I)
Terms in this set (41)
How does the body compensate within in minutes?
If too much acid..
hyperventilate to drive down carbon dioxide
If too little acid...
hypoventilate to INCREASE cardon dioxide
How long does it take for kidney compensation?
hours to days
kidneys retain bicarb
kidneys excrete bicarb
CO2 retention (high H+ concentration)
A patient has COPD or in CNS depression and respiratory acidosis state, how will their body compensate?
A patient with intense anxiety or pain CNS lesions is in a respiratory alkalosis state, how will their body compensate?
Metabolic acidosis type of patients..
renal failure, ketoacidosis (DM), diarrhea (loose bicarb)
Metabolic alkalosis type of patients...
bicarb ingestion (tums), vomiting, gastric suction, iatrogenic
Normal Blood pH range=
Three self regulatory systems to maintain normal blood pH?
respiratory, renal, and protein buffers (minor role)
Normal Carbon Dioxide level=
Normal bicarbonate level=
Normal PaO2 (partial pressure of O2 dissolved in blood) level
Normal PaCO2 (partial pressure of CO2 dissolved in blood) level
Normal HCO3 level
what does SaO2 stand for?
arterial O2 saturation
True or False: Base excess can be used to determine if there is bicarbonate insufficiency in the blood.
True (BE indicates excess OR insufficiency)
What are the normal limits of base excess?
+/- 2 (mEq/L)
Talk about the three step approach to interpreting ABGs.
1. Assess pH first to determine if condition is acidosis or alkalosis.
2. If pH is abnormal, determine if cause is primarily respiratory or metabolic by assessing PaCO2.
3. If pH is abnormal and CO2 is normal, look at HCO3.
The pH is abnormal due to a metabolic cause. Is the PaCO2 low/normal/high if the patient is UNCOMPENSATED?
If low pH is caused by a metabolic problem, will the HCO3 be low or high if UNCOMPENSATED?
Case Study 1: Jane Doe is a 45-year-old female with severe asthma attack and increasing SOB. pH: 7.22; PaCO2: 55; HCO3: 25
Uncompensated respiratory acidosis
Case Study 2: John Doe has a recurring bowel obstruction with vomiting for the last several hours. pH: 7.5; PaCO2: 42; HCO3: 33
uncompensated metabolic alkalosis
pH low or high and HCO3 normal=
What occurs over a period of time when acid base imbalance exists?
What is the primary system the body uses for compensation?
What is the primary goal of compensation?
return blood pH back to normal range
A patient can be uncompensated, compensated, OR...?
True or False: The respiratory system can sometimes overcompensate for metabolic pH problems.
False (neither system has the ability to overcompensate)
True or False: With uncompensated and partially compensated, the pH remains outside of normal limits.
True or False: Fully compensated states allow pH, PCO2, and HCO3 to return to normal range.
False (pH will return within normal range, but other values may still be abnormal)
What is the only difference between partially and fully compensated acid-base disorders?
pH will frequently fall on either the low or high side of neutral
Case Study 3: Jack Smack is supposed to be on renal dialysis, but he has been skipping out. pH: 7.32; PaCO2: 32; HCO3: 18
uncompensated metabolic acidosis
In respiratory acidosis and alkalosis, CO2 and pH are opposite or the same?
Opposite (increase, decrease or decrease increase)
In metabolic acidosis and alkalosis, CO2 and pH are opposite or the same?
SAME (increase, increase or decrease decrease)
Metabolic or respiratory compensation is faster?
Metabolic- because it utilize lungs
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