Acid- Base Determination
Terms in this set (59)
normal systemic arterial pH
pH < 7.35
carbonic acid: respiratory or metabolic
fats and carbs
eliminated by lungs
ingested sulfates and phosphates
eliminated by kidneys
HSO4 and H2PO4
__________ most important in intracellular fluid and renal tubular fluid
phosphate buffer system
the majority of the body's buffering occurs where?
most important overall buffer system
what are the intracellular buffers
maintenance of acid base balance requires?
reabsorption of filtered bicarbonate
excretion of acid
T/F: kidneys are not able to excrete free hydrogen ions
net acid excretion (NAE)= ?
NAE= (titratable acidity + NH4) - urinary HCO3
urinary HCO3 should = ?
how does H+ get excreted?
through the form of ammonium (NH4)
titratable acid dependent on daily _____ intake
regulated by brain stem - cerebral pH
pulmonary acid excretion
what can mimic normal labs
net loss of bicarb from ECF
anion gap= ?
Na - HCO3 - Cl
normal range for anion gap
increase anion gap causes?
increased unmeasured anions
decreased unmeasured cations
what are the unmeasured anions
what are the unmeasured cations
MUDPILES and USEDCAR are causes of?
which acronym (MUDPILES or USEDCAR) is for increased anion gap metabolic acidosis
which acronym (MUDPILES or USEDCAR) is for normal anion gap metabolic acidosis
what does MUDPILES stand for
Also: Rhabdomyolysis, renal failure
what does USED CAR stand for
Carbonic anhydrase inhibitors
Renal Tubular acidosis
also: chlorine gas exposure, hyperalimentation
salicylates causes what mixed disorder
what formula is used to determine whether or not the compensation is appropriate
increased CO2 --> increased ?
plasma carbonic acid
in the treatment of chronic resp acidosis caused by COPD only use O2 if paO2 is < ____ mmHg
which is more common: metabolic alkalosis or metabolic acidosis
causes of ____:
vomiting or gastric suction
ingestion of alkaline drugs
if the cause of metabolic alkalosis is unclear then measure?
low urinary Cl- in metabolic alkalosis suggests?
vomiting, NG suction
high urinary Cl- in metabolic alkalosis suggests?
diuretics, hypokalemia, mineralocorticoid excess
carbonic anhydrase inhibitor - acetazolamide (Diamox) is used in the treatment of?
hydrochloric acid as a treatment for metabolic alkalosis is preferred in?
these are alternatives for the treatment of?
pH > 7.5
lung disease with or without hypoxia; decreased lung compliance--interstitial fibrosis can cause?
treatment is usually not required for what disorder
treat pain, anxiety, fever, infection, or salicylate over dose in what disorder
arise when compensation is incomplete
mixed acid-base disorder
3- step approach to a mixed disorder
establish primary disturbance
serum anion gap determination
evaluation of compensation
decreased pH, decreased HCO3-
increased pH, increased HCO3-
decreased pH, increased CO2
increased pH, decreased CO2
pCO2 > expected then?
concurrent resp acidosis
pCO@ < expected then?
concurrent resp alkalosis
steps in acid base diagnosis
obtain ABG and electrolytes simultaneously
compare HCO3- on ABG and electrolytes to verify accuracy
calculate anion gap
estimate compensatory response
what are the four causes of high anion gap acidosis
what are the two causes of hyperchloremic or non-gap acidosis
bicarbonate loss from GI tract
renal tubular acidosis