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16 terms

Assessment of Acid-Base Balance

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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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