Unit 8 Acid-Base Balance

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harstanner
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107972
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Unit 8 Acid-Base Balance
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2011-10-13 00:48:26
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Unit Acid Base Balance
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Unit 8 Acid-Base Balance
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  1. Body fluids must maintain an ___________ balance to sustain health, homeostasis, and life
    acid-base
  2. Conditions such as infection or trauma may alter this
    delicate ______________
    acid-base balance
  3. Unit of measure to describe acid-base balance is
    pH
  4. pH of water is
    7 (neutral)
  5. Blood pH is
    7.35-7.45
  6. The ____________ of pH is achieved through 3 regulators: —chemical buffer system, —Respiratory system, —Renal system
    narrow range
  7. Acid-base ____________ occur when the carbonic acid (acid) or bicarbonate (base) levels become disproportionate
    imbalances
  8. -—Metabolic acidosis
    -—Metabolic alkalosis
    -—Respiratory acidosis
    -—Respiratory alkalosis
    Names of imbalances
  9. —Cause by ___________________; Chronic obstructive pulmonary disease (COPD),
    —Hyperventilation, —Renal failure, —Prolonged use of
    antacids/vomiting
    respiratory or metabolic problems
  10. pH <7.35
    Acidosis
  11. pH >7.45
    —Alkalosis
  12. Normal pH
    7.35-7.45
  13. <7.35 =
    acid
  14. >7.45 =
    base
  15. Normal PaC02: _________ mm Hg
    35-45
  16. Normal HCO3: ________ mEq/L
    22-26
  17. Excess carbonic acid in ECF; Low pH (7.35), High PaCO2 (>45)
    Respiratory Acidosis
  18. Causes: —Hypoventilation-COPD, narcotics, paralysis
    Respiratory Acidosis
  19. Respiratory rate increases to blow off CO2 (acid)
    Respiratory Acidosis
  20. Kidneys will excrete hydrogen (acid) and conserve bicarb (base)
    Respiratory Acidosis
  21. Deficit of carbonic acid in ECF; High pH (>7.45), Low PaCO2 (<35)
    Respiratory Alkalosis
  22. Causes: —Hyperventilation-fever, pain, fear/anxiety, ventilator rate too fast
    Respiratory Alkalosis
  23. Body is stimulated to breathe slower and more shallow
    Respiratory Alkalosis
  24. Kidneys will increase bicarb (base) excretion and
    retain more hydrogen (acid)
    Respiratory Alkalosis
  25. Deficit of bicarbonate in ECF; Low pH (<7.35), Low bicarb (<22
    Metabolic Acidosis
  26. Causes: —Increased acid or excessive loss of bicarb (base), —Renal failure, —Overdose of ASA (aspirin)
    Metabolic Acidosis
  27. Lungs attempt to increase CO2 excretion by increasing rate and depth of respirations
    Metabolic Acidosis
  28. Kidneys attempt to compensate by retaining bicarb and excreting more hydrogen (acid)
    Metabolic Acidosis
  29. Excess bicarb or deficit of hydrogen or both; High pH (>7.45), High bicarb (>26)
    Metabolic Alkalosis
  30. Causes: —Loss of acids (vomiting/diarrhea), —Ingestion of base (antacids)
    Metabolic Alkalosis
  31. 1. Slowed breathing (retain CO2- acid), 2. kidneys excrete bicarb (base) and retain hydrogen (acid)
    Metabolic Alkalosis
  32. Complete blood count
    CBC
  33. Basic/complete metabolic panel
    BMP/CMP
  34. —May be more accurate at detecting fluid imbalances
    Daily weights
  35. ____________ — patient at same time every day, same scale, same type of clothes
    Weigh
  36. —1 kg (gain or loss) =
    1 Liter fluid
  37. —Normal pH: 4.6-8.2
    Urine pH
  38. —Normal specific gravity: 1.005- 1.030
    Urine specific gravity
  39. can cause severe diarrhea
    —Kayexalate
  40. NEVER give IV ___________ fast
    potassium
  41. does not force fluid in or out of the cells
    Isotonic
  42. Contain fluids and electrolytes normally found in the
    body
    IV Solutions
  43. Used as a maintenance fluid to compensate for mild fluid losses
    IV Solutions
  44. Require large volumes to be effective (multiple liters)
    IV Solutions
  45. Can result in edema when given in large doses
    IV Solutions
  46. -Treat hypovolemia
    -Fluid replacement with a little sugar
    5% dextrose in water (D5W or D5)
  47. -Temporary
    -With blood products
    —0.9%NaCl (Normal saline or NS)
  48. -Treat hypovolemia
    -Provides electrolytes
    Lactated Ringer’s (LR)
  49. -—5% dextrose in water (D5W or D5)
    -—0.9%NaCl (Normal saline or NS)
    -—Lactated Ringer’s (LR)
    Isotonic/Crystalloids
  50. -—Water is pulled into cells by osmosis
    -—Can worsen hypotension
    IV solutions - Hypotonic
  51. Fluid replacement with kidney problems
    0.33% NaCl (1/3 NS)
  52. -Treat hypernatremia
    0.45% NaCl (1/2 NS)
  53. - —Pull water from cells back into circulation
    - Correct electrolyte imbalances
    - —Resuscitation- suppresses inflammation
    IV solution - Hypertonic
  54. Treat hypovolemia
    —5% dextrose in 0.45% NaCl (D5 ½ NS)
  55. Peripheral parenteral nutrition (PPN)
    10% dextrose in water (D10W or D10)
  56. Treat hypovolemia
    5% dextrose in 0.9% NaCl (D5NS)
  57. Treatment or prevention of potassium depletion in
    patients whenever dietary measures are inadequate
    Potassium Replacement
  58. Adverse effects: —GI with oral administration- N/V/D, GI bleed (GIB), pain at injection site for IV administration, cardiac arrest if given too rapidly
    Potassium Replacement

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