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What is the most important buffer system?

The bicarbonate buffer system

How do the respiratory and renal systems work together to control acid-base balance?

Lungs eliminate CO2; Kinneys regenerate and conserve (reabsorb) NaHCO3- and elimniate H+

What are the potential causes of metabolic acidosis?

1) ketoacidosis: starvation and alcoholism 2) lactic acidosis: circulatory shock, cardiac failure, acute pulmonary edema 3) renal disease: impaired reabsorption of Bicarbonate and less secretion of H+ 4) Excess Intake of acid: Aspirin poisoning 5) Diarrhea: losses of biocarbonate

What are the characteristic lab findings of metabolic acidosis?

1) decreased bicarbonate 2) decreased pH 3) normal or decreased PCo2 4) normal or increased Cl 5) usually higher potasium

What are the potential causes of metabolic alkalosis?

1) loss of acid containing fluid from GI tract: vomiting, NG suction 2) Diuretic therapy: loss of acid from kidney 3) excess intake of alkali: antacids, baking soda 4) excess addition of bicarbonate precursors to parenteral nutrition: acetate, lactate

What are the characteristic lab findings of metabolic alkalosis?

1) increased pH 2) increased Bicarbonate 3) normal or increased PCo2 4) Normal or decreased Cl 5) usually decreased potassium

Respiratory compensation in metabolic acidosis

lungs increases ventilation and elimination of CO2

Respiratory compensation in metabolic alkalosis

Lungs decrease ventilation and elimination of CO2

In which type of metabolic acid-base disorder would you expect to see hyperkalemia? What causes this to occur?

Metabolic acidosis. I think it might be, potassium comes out of intracellular in to raise the pH

What are the potential causes of respiratory acidosis?

Lungs not providing adequate ventilation: cronich obstructive pulmonary disease, acute respiratory distress syndrome, asthma, obesity, CNS injury, hypoventilation with a mechanical ventilator

Lab findings with respiratory acidosis

decreased pH, increased PCO2, increased bicarbonate

Compensatory changes by the kidney in respiratory acidosis

increased reabsorption of bicarbonate

Potential causes of respiratory alkalosis

Lungs providing excessive ventilation

Lab findings of respiratory alkalosis

increased pH, decreased PCO2, decreased HCO3

Compensation by kidney in respiratory alkalosis

decreased reabsorption of bicarbonate via increased excretion

Understand uncompensated, partially compensated, and compensated


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