Acid Base Part 2.txt

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Acid Base Part 2.txt
2011-12-06 18:05:45
RESP 130

RESP 130
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  1. Are the primary acid-excreting organs.
    Lungs and kidneys
  2. These excrete volatile (CO2) to lower H2CO3
  3. Removes H+ rom the body.
  4. Eliminating of substances from the body in the urine.
  5. The process by which blood substances diffuse into renal tubule cells, whuch they actively transport them into the fluid (filtrate) within the tubular cell.
  6. The active or passive transport of filtrate substances back into the tubule cell, and then into the blood of nearby capillaries
  7. Regulates the excretion of H+ ions and the reabsorption of HC)3- ions.
    Basic Kidney Function
  8. There is high blood CO2, Acidic pH, and high level of H+
  9. The kindneys will try to reabsorb all filtrate HCO3 in the blood when this happens.
  10. Low blood CO2, Alkaline pH, and low level H+.
  11. The kidneys will try to increase the quantity of HCO3- in the urine when this happens.
  12. If no buffers existed in the filtrate to react with H+, the seceting mechanism will?
    Cease to function
  13. Any extra H+ remaining after the bicarbinate bufffers are exhausted, will react with two other filtrate bufer:
    Phosphate and ammonia
  14. This buffer show up with excess H+, allows the kidneys to further increase their excretion of H+ ions, combines w/ excess H+ to form H2PO4-, and Na+ and HCO3- are reabsorbed in exchange for H+ ions.
    Phosphate buffer
  15. In responce to low filtrate pH, allows for elimination of H+ and C- ions w/o effecting the urine pH.
    Ammonia Buffer
  16. A chloride is excreted in the urine, a _______is gained.
    Bicrabonate HCO3
  17. These secrete ammonia in responce to low-filrate pH.
    Tubule Cells
  18. norm pH range.
  19. normal PaCO2 range
  20. normal HCO3- range
  21. Normal acid base balance.
  22. is when the blood pH is greater than 7.45
  23. is when the blood pH is less than 7.35
  24. is when PaCO2 is less than 35 mmHg
  25. is when PaCO2 is greater than 45 mmHg
  26. changes in pH caused by change in PaCO2.
    Primary Respiratory Disturbance
  27. pH decreased, PaCO2 increased, HCO3 is normal.
    Resp. Acidosis (hypovent)
  28. pH increased, PaCO2 decreased, HCO3 is normal.
    Resp. Alkalosis (Hypervent)
  29. Change in pH due to gain or loss of fixed acids or HCO3
    Primary Metabolic Disturbances
  30. pH decreased, PaCO2 is normal, HCO3 is decreased.
    Metabolic acidosis
  31. pH is increased, PaCO2 is normal, HCO3 is increased.
    Metabolic alkalosis
  32. This is restoring pH to normal. The body will initiate this respoce to any primary acid-base defects.
    Compensation ( compensatory responce)
  33. the kidneys will restore pH toward normal by reabsorbing HCO3 into the blood when this is happening.
    Repisatory acidosis (hypovent.)
  34. the kidneys will eliminate HCO3 in the urine when this is hapening.
    Respiratory alkalosis (hypervent.)
  35. the lungs will compensate by hyperventilating when this occurs.
    metabolic acidosis
  36. the lungs will compensate by hypoventilating when this is occuring.
    metabolic alkalosis
  37. Arterial HCO3 does increase slightly as the PaCO2 rises, because the CO2 hydration reaction generates HCO3. THis happens due to a RBC catalytic enzyme called?
    Carbonic anhydrase
  38. Rule of thumb: if the PCO2 increases acutely, the plasma [HCO3] rises _____ mEq/L for every 10 mmHg increase in PCO2 above _______.
    1 mEq/L 40 mmHg
  39. Systematic Acid-Base Classification: Step 1
    Categorize the pH
  40. Systematic Acid-Base Classification: Step 2
    Determine Respiratory involvement
  41. Systematic Acid-Base Classification: step 3
    determine metabolic involvement
  42. Systematic Acid-Base Classification: step 4
    assess for compensation
  43. increased PaCO2 is synonymous with respiratory acidosis.
  44. Any process on whcih alveolar ventilation fails to eliminate CO2 as rapidly as the body produces it.
    Causes of Resp. Acid.
  45. Compensation of Resp. acid.?
    kidney reabsorbs HCO3
  46. has a high PaCO2, a High HCO3, and an acid pH not quite in normal range.
    part. comp. resp. acid.
  47. characterized by a pH on the acid side of normal range >/= 7.35 by <7.40 ex: pH 7.35 PCO2 55 HCO3 32 BE +4
    fully comp. resp. acid.
  48. How can you correct acidosis?
    Improve alveolar ventilation
  49. Various repiratory care modalities for improving alveolar vent.
    bronchial hygiene breathing manuevers, endotracheal intubation, and mechanical ventilation
  50. if hypventilation is chronic, rapidly reducing PCO2 to normal is?
    inappropriate and harmful.
  51. a low PaCO2 is sysnonmous with respiratory alkalosis.
  52. any process in which ventilary elimination of CO2 exceeds its production causes.
    resp. alk.
  53. Clinical signs: paresthesia, severe hyperventilation, hyperactive reflexes, tetanic convulsions, low PaCO2
    Resp. Alk.
  54. characterized by a low PaCO2, a low HCO3 and an alkaline pH- not quite in the normal range.
    part. comp. resp. alk.
  55. characterized by a low PaCO2, low HCO3, and a pH on the alkaline side of normal (> 7.4 but
    fully comp. resp. alk.
  56. Removing the stimulus causing hyperventilation is a correction for what?
    Respiratory Alkalosis
  57. the number one cause for Respiatory alkalosis is?
  58. Stopped at slide
  59. Reference pg 294 for all causes and 298.