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Acid-Base Balance NCLEX

Terms in this set (78)

1) bicarb
2) hydrogen
3) CO2
What are 3 major important chemicals you have to remember?
CO2---> acid
What is the major lung chemical?
bicarb__> base
hydrogen-->acid
What are the 2 important kidney chemicals?
if the blood is acidic, alkaline, or basic
What does the pH tell you about the blood?
7.35-7.45
What is the normal pH range?
acidosis ... can lead to coma then death
pH below 7.35
alkalosis .. can lead to convulsions then death
pH above 7.45
urine; bicarb
The kidneys remove acid through _____ and hold onto ____ and return to the blood
excrete; hours to days
or kidneys can ____ through the urine; kidneys take ____ to do their job
exhalation
one of the ways lungs get rid ofCO2 is what?
hypoventilation
retain CO2
hyperventilation
eliminate CO2
fast
lungs respond....
80-100
What is the normal range for PaO2?
35-45
What is the normal range for PaCO2?
22-26
What is the normal range for HCO3?
lungs
In respiratory acidosis what is the problem?
CO2
What chemical is causing the problem in respiratory acidosis?
too much .. retaining too much acid
In respiratory acidosis, do we have too much or too little of CO2?
hypoventilating
is the patient hypoventilating or hyperventilating in respiratory acidosis?
kidneys
What is going to compensate in respiratory acidosis?
bicarbonate and hydrogen
What chemicals do the kidneys compensate with?
excrete ; bicarb
In respiratory acidosis.... the body must_____ acid and retain ___
below 7.35
What is the pH in respiratory acidosis?
decreased LOC
decreased oxygen
increase CO2 leads to
1) retain CO2..not taking good enough breaths
2) mid-abdominal incision
3) narcotics
4) sleeping pills
5) pneumothorax
6) collapsed lung
7) pneumonia
What are 7 causes of respiratory acidosis?
-headache, confusion, sleepy
-not corrected, leads to coma
-hypoxic
what are 3 signs of respiratory acidosis?
1) give them oxygen
if a patient is hypoxic what must you do
restlessness and tachycardia
2 early signs of hypoxia?
think hypoxia
restlessness think what first?
1) fix the breathing problem
2) treat pneumonia, get rid of secretions
3) pneumothorax clients will have chest tubes
4) encourage post-op clients to turn, cough and deep breathe
What are 4 treatment options for respiratory acidosis?
-postural drainage
-percussion (vibration therapy)
-deep breathing exercises
-suctioning
-fluids
-elevate HOB
-incentive spirometry
What are some treatment options to treat pneumonia and get rid of secretions?
lungs; kidneys
In respiratory alkalosis, which organ is sick? which organ is going to compensate?
bicarb; hydrogen
In respiratory alkalosis, kidneys excrete.... and retain...
CO2
What is the problem chemical in respiratory alkalosis?
losing
Is a patient gaining or losing CO2 in respiratory alkalosis?
hyperventilating
Is a patient hyperventilating or hypoventilating in respiratory alkalosis?
above 7.45
What is the pH in respiratory alkalosis?
1) hyperventilation
2) hysterical .. client is breathing too fast, removing CO2
3) acute aspirin overdose
What are 3 causes of respiratory alkalosis?
-lightheaded
-faint feeling
-peri-oral numbness... around mouth
-numbness and tingling in fingers and toes
What are symptoms of respiratory alkalosis?
-do not wait for kidneys to kick in
-breathe into paper bag, cupped hands
-may have to sedate client to decrease respiratory rate
-treat the cause
What are some treatment options for Respiratory Alkalosis?
kideys; lungs
In Metabolic Acidosis, what organ is sick? What organ is going to compensate?
CO2
In Metabolic Acidosis, what chemical is used to compensate?
bicarb and hydrogen
What is the 2 problem chemicals in Metabolic Acidosis?
hydrogen; bicarb
In metabolic acidosis, the client is retaining_____ or does not have enough _____
below 7.35
What is the pH in Metabolic Acidosis?
respiratory rate; lungs will compensate...Kussmaul respirations to bring down the acid
What increases in Metabolic Acidosis?
1) DKA
2) Starvation
3) renal failure
4) severe diarrhea
What are 4 main causes of Metabolic Acidosis?
glucose; protein and fat; ketones; acid
In Metabolic Acidosis, cells are starving for ____, so the body will break down ____ and ____, and produce _____; ketones are ____
GI tract has a lot of bicarb; losing base
Why might severe diarrhea cause metabolic acidosis?
1) Hyperkalemia
2) muscle twitching, muscle weakness, flaccid paraylis and arrythmias
3) increased respiratory rate .. pt. trying to remove CO2
What are some symptoms of Metabolic Acidosis?
IV sodium bicarb
What drug can be used to help with Metabolic Acidosis but doesn't exactly fix the issue?
kidneys; lung
In Metabolic Alkalosis, what organ is sick? what organ is going to compensate?
CO2
What chemical is used to compensate in metabolic alkalosis?
bicarb and hydrogen
What are the 2 problem chemicals in metabolic alkalosis?
bicarb; hydrogen
The client in metabolic alkalosis is retaining too much____ and excreting ____
above 7.45
What is the pH in metabolic alkalosis?
1) loss of upper GI contents or NG tube suctioning
2) too many antacids .. too much base
3) too much IV bicarb
What are 3 causes of Metabolic alkalosis?
-observe LOC
-hypokalemia
-muscle cramps
-llife threatening arrythmias
symptoms in metabolic alkalosis?
replace K+
Treatment for metabolic alkalosis?
hyperkalemia
Metabolic Acidosis=
hypokalemia
Metabolic Alkalosis=
pH is abnormal
partially compensated?
pH is normal
fully compensated?
all values are usually abnormal
- find the value that matches the pH
What makes you suspected compensation?
alkalotic side
Any pH greater than 7.4 in on the...
acidotic side
Any pH less than 7.4....
base
Bicarb is a what?
acid
Hydrogen is a what?
acid
CO2 is a what?
basic
PCO2 less than 35?
acidotic
PCO greater than 45?
acidotic
HCO3 less than 22?
base
HCO3 greater than 26?
metabolic acidosis
pH :7.32
PCO 2: 41
HCo3: 20
respiratory alkalosis
pH : 7.56
PCO2: 31
HCO3: 25
partially compensated respiratory acidosis
pH: 7.26
PCO2: 51
HCO3: 29
fully compensated metabolic alkalosis
ph: 7.45
PCO2: 52
HCO3: 35
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