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44 terms

CAUSES OF RESPIRATORY ACIDOSIS, RESPIRATORY ALKALOSIS, METABOLIC ACIDOSIS, & METABOLIC ALKALOSIS and 2 others

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RESPIRATORY ACIDOSIS
ASTHMA.
ATELECTASIS.
BRAIN TRAUMA.
BRONCHIECTASIS.
BRONCHITIS.
CNS DEPRESSANTS.
EMPHYSEMA.
HYPOVENTILATION.
PULMONARY EDEMA.
PNEUMONIA.
PULMONARY EMBOLI.
RESPIRATORY ALKALOSIS
FEVER.
HYPERVENTILATION.
HYPOXIA.
HYSTERIA.
PAIN.
OVERVENTILATION CAUSED BY MECHANICAL VENTILATORS.
METABOLIC ACIDOSIS
DIABETES MELLITUS.
DIABETIC KETOACIDOSIS.
EXCESSIVE DIGESTION OF ASPIRIN.
HIGH-FAT DIET.
INSUFFICIENT METABOLISM OF CARBS.
MALNUTRITION.
RENAL INSUFFICIENCY.
RENAL FAILURE.
SEVERE DIARRHEA.
METABOLIC ALKALOSIS
DIURETICS.
EXCESSIVE VOMITTING.
EXCESSIVE SUCTIONING.
HYPERALDOSTERONISM.
INGESTION/INFUSION OF EXCESS SODIUM BICARBONATE.
MASSIVE TRANSFUSION OF WHOLE BLOOD.
what 2 things cause RESPIRATORY ACIDOSIS?
Drugs (barbiturates, morphine)
Disease (emphysema, pneumonia)
whats the rationale for RESPIRATORY ACIDOSIS caused by DRUGS?
INHIBIT RESPIRATORY CENTER
whats the rationale for RESPIRATORY ACIDOSIS caused by DISEASE?
HYPOVENTILATION
what 3 things cause METABOLIC ACIDOSIS?
Diabetes mellitus
Ingestion of ammonium
Diarrhea
whats the rationale for METABOLIC ACIDOSIS caused by DIABETES MELLITUS?
Inability to use glucose can lead to an accumulation of acids. Excess bicarbs may be excreted
whats the rationale for METABOLIC ACIDOSIS caused by INGESTION OF AMMONIUM?
Ammonium ions (NH4+) salts can donate H+s
whats the rationale for METABOLIC ACIDOSIS caused by DIARRHEA?
loss of bild and bicarbs from pancreas and intestine
what 2 things cause RESPIRATORY ALKALOSIS?
High altitude exposure
Emotional disorders or aspirin (salicylate) poisoning
whats the rationale for RESPIRATORY ALKALOSIS caused by HIGH ALTITUDE EXPOSURE?
Prolonged exposure above 13,000ft may stimulate hyperventilation
whats the rationale for RESPIRATORY ALKALOSIS caused by EMOTIONAL DISORDERS OR ASPIRIN (SALICYLATE) POISONING?
Stimulates hyperventilation
what 3 things cause METABOLIC ALKALOSIS?
Ingestion of excess alkali (bicarb or antacids)
Prolonged vomiting of gastric contents
Some diuretics
whats the rationale for METABOLIC ALKALOSIS caused by INGESTION OF EXCESS ALKALI (BICARB OR ANTACIDS)?
May cause excess bicarb ions in body fluids
whats the rationale for METABOLIC ALKALOSIS caused by PROLONGED VOMITING OF GASTRIC CONTENTS?
Loss of chloride from stomach lowers acid levels leaving excess alkaline bicarb
whats the rationale for METABOLIC ALKALOSIS caused by SOME DIURETICS?
Stimulate Cl- and Na+ excretion or loss thus leaving excess bicarb
Physiological pH must be maintained at what level?
1. Physiological pH must be maintained between the range of 7.35-7.45.
What are the reasons pH must be maintained
There are many reasons that pH must be maintained. For one imbalances in distribution of hydrogen ions (H+) cause shifts in other ions such as sodium and potassium. Changes in sodium and potassium ion distribution affect the function of many bodily processes, including the function of the heart and nervous system.
What exists in body to maintain pH
2. Numerous buffering systems exist in body to maintain pH
What is the primary buffering system
a. Primary buffering system is Bicarbonate (base) - Carbonic acid (acid) system.
What 2 organs regulate the buffering system
Regulation of this buffering system is controlled by the lung and kidney.
What are the 2 acids involved in the buffering system
B. Carbonic acid-bicarbonate buffering system: (FYI H2CO3/HCO3-)
What does carbon dioxide form in the buffering system?
1. Carbonic acid forms from carbon dioxide.
Explain the process of how the lungs regulate carbonic acid levels.
The lungs regulate carbonic acid levels and compensate for changes in blood pH by changing ventilation. In other words, by modulating ventilation, the lung can increase the amount of carbonic acid (making blood more acidic) or decrease the amount of carbonic acid (making blood less acidic).
What organ regulates bicarbonate
Kidneys are responsible for the regulation of bicarbonate levels in the body.
How does the kidney regulate bicarbonate levels?
2. The kidney regulates bicarbonate levels by excreting more bicarbonate or increasing reabsorption of filtered bicarbonate.
Can the kidney generate new bicarbonate?
Yes, the kidney also generates new bicarbonate.
Acidosis
results when blood pH drops below 7.35
Alkalosis
results when blood pH increases above 7.45
Name the two descriptive terms that relate to the source of the changes in pH.
1. "Respiratory" refers to a pH change caused by increased or decreased carbonic acid
2. "Metabolic" refers to a pH change caused by increased or decreased bicarbonate and/or from metabolic processes
Name the 4 types of acidosis/alkalosis
1. "Respiratory acidosis" = caused by increased carbonic acid.
2. "Respiratory alkalosis" =caused by decreased carbonic acid.
3. "Metabolic acidosis" = caused by decreased bicarbonate, and/or buildup of acids from metabolic processes.
4. "Metabolic alkalosis" = caused by increased bicarbonate.
III. What causes disturbances in pH?
A. Metabolic acidosis - this is quite common in medical practice. Examples include:
1. Kidney failure
2. Ketosis = excess production of ketone bodies (examples: "ketoacidosis" in diabetes) in malnutrition, people on "ketonic diets" for weight loss)
3. Lactic acidosis (over-production of lactic acid that occurs from heart failure -> hypoxia resulting in anaerobic glucose metabolism).
4. Take note of the fact that the problem doesn't necessary begin with the kidney - but it reflects difference in bicarbonate levels caused by "metabolic" processes throughout body.
Describe Respiratory acidosis
1. Caused by failure of lungs to excrete CO2 efficiently.
2. Occurs with certain lung diseases such as emphysema, COPD.
Describe Metabolic alkalosis
Can be caused by loss of gastric acid (vomiting) or over-neutralization with antacids.
Describe Respiratory alkalosis
Caused by hyperventilation leading to "blowing off" too much CO2.
Describe compensatory mechanisms used by the body in response to: A: Metabolic acidosis
1. Increased ventilation (hyperventilation) to release more CO2 (decrease PaCO2 and thus carbonic acid).
2. Kidney retains/forms more bicarbonate, excretes more H+
Describe compensatory mechanisms used by body in response to: B. Respiratory acidosis
Kidney retains/forms additional bicarbonate, excretes more H+
Describe Compensatory mechanisms used by body in response to:A. Metabolic acidosis
1. Increased ventilation (hyperventilation) to release more CO2 (decrease PaCO2 and thus carbonic acid).
2. Kidney retains/forms more bicarbonate, excretes more H+
Describe Compensatory mechanisms used by body in response to B. Respiratory acidosis
Kidney retains/forms additional bicarbonate, excretes more H+
C. Metabolic alkalosis Compensatory mechanisms are not particularly effective
Describe compensatory mechanisms used by body in response to: D. Respiratory alkalosis.
Kidney conserves H+ and increases excretion of bicarbonate.
Describe compensatory mechanisms used by body in response to: C. Metabolic alkalosis
Compensatory mechanisms are not particularly effective
Normal lab values
pH 7.35 - 7.45
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