306 Acid/Base

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Author:
KristaDavis
ID:
170193
Filename:
306 Acid/Base
Updated:
2012-09-11 01:42:04
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306 Acid Base
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Exam 1
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  1. Releasing a hydrogen atom makes the atom more:
    ACIDIC
  2. Accepting or combining with hydrogen atoms makes the atom more of a:
    BASE
  3. Weak Acid
    • Carbonic Acid
    • H23O2
  4. Weak Base
    • Bicarbonate
    • HCO3
  5. Acid-Base Balance--
    regulation of hydrogen ions
  6. Acidity or alkalinit is measured as:
    pH
  7. Normal pH Levels:
    Ph- 7.35- 7.45
  8. More Hydrogen ions, More acidic = _______ pH
    lower pH
  9. Lower hydrogen ions, More alkaline= _____ pH
    higher pH
  10. 3 ways to regulate the pH:
    1. Intra- and extracellular buffering systems

    2. Lungs- elimination of CO2

    3. Kidneys- reabsorb HCO3 and eliminate hydrogen
  11. HCO3 = 
    Bicarbonate
  12. Body Proteins buffering sytem:
    • Amphoteric
    • Can release or bind hydrogen
    • Vascular buffers- albumin and plasma globulins
  13. 2. Bicarbonate Buffer System
    • Uses carbonic acid and bicarbonate
    • Acts rapidly
    • CO2 eliminated by lungs
    • Kidney can form bicarbonate
    • Kidney can excrete bicarbonate
  14. What system is used in a rapidly declining patient because it is fast acting?
    Bicarbonate Buffer System
  15. Transcellular Hydrogen-Potassium Exchange System
    • Can move freely between compartments.
    • Hydrogen in ECF, moves in cell in exchange for potassium.
    • Potassium in ECF, moves in cell in exchange for hydrogen.
  16. Respiratory Mechanisms:
    *Respiratory control of pH is rapid

    *Can eliminate or retain CO2

    *Normal CO2 is 35 to 45 mmHg

    *Lungs cannot eliminate hydrogen
  17. Getting the body back as close to normal as possible:
    • Compensation
    • (**Lungs cannot eliminate hydrogen)
    • **KNOW VALUES
  18. Renal Control Mechanisms
    *Long-term regulator

    • ROLES:
    • Reabsorption of bicarbonate
    • Excretion of hydrogen

    Normal bicarbonate level- 22 to 26 mEq/L
  19. -alteration in bicarbonate concentration
    Metabolic Disorders
  20. -alteration in carbon dioxide concentration
    Respiratory Diseases
  21. -adjusts the pH toward normal, does not correct etiology. Different than cause (lungs, kidney)
    • Compensation 
    • (other systems kick in to try to get the body back to where it needs to be)
  22. Metabolic Acidosis:
    -Ph low < 7.35, bicarb low < 22
  23. What causes Metabolic Acidosis:
    • Increased nonvolatile metabolic acids
    • Decreased acid secretion by kidneys
    • Excessive loss of bicarb
    • Increased chloride
  24. Manifestations of Acidosis:
    • GI- anorexia, N/V
    • Neuro- Weakness, lethargy, confusion, stupor, coma
    • CV- Bradycardia, dysrhythmias
  25. Compensation of Acidosis:
    • ph low < 7.35
    • bicarb low < 22
    • PCO2 low <35

    • Kussmaul’s breathing
    • Hyperkalemia
    • Acid urine
  26. Metabolic Alkalosis
    pH high > 7.45, bicarb high > 26
  27. What causes Metabolic Alkalosis
    • Loss of hydrogen/ gain of bicarb
    • Cannot excrete excess bicarb
    • Excessive alkali intake
    • Hydrogen, chloride, potassium loss/bicarb retention
  28. Manifestations of Metabolic Alkalosis
    • CV- Dysrhythmias, hypotension
    • Neuro- Hyperreflexia, tetany, confusion, seizures
  29. *At what point is pH dangerously high (causing seizers, coma, respiratory, failure)
    pH 7.55
  30. Compensation of Metabolic Alkalosis:
    • pH high > 7.45,
    • bicarb high > 26, 
    • PCO2 high > 45
  31. Respiratory Acidosis:
    • pH high > 7.45,
    • bicarb high > 26, 
    • PCO2 high > 45
  32. What causes respiratory acidosis:
    • Hypoventilation
    • Excessive CO2 production
  33. Manifestations of Respiratory Acidosis
    • Sudden: Increased HR, B/P, Cerebral vasodilation
    • Decreased neuro activity
  34. Compensation from Respiratory Acidosis:
    • pH low < 7.35,
    • PCO2 high > 45,
    • bicarb high > 26
  35. Respiratory Alkalosis
    Ph high > 7.45, PCO2 low < 35
  36. What causes Respiratory Alkalosis
    • Hyperventilation
    • Stimulation medullary respiratory center
  37. Manifestations of Respiratory Alkalosis:
    • Neuro/decreased cerebral blood flow:
    • light headed, numbness, tetany, seizures
  38. Compensation for Respiratory Alkalosis
    ph high > 7.45, PCO2 low < 35, bicarb low < 22
  39. Interpreting:
    *Look at pH (acidosis <7.35 or alkalosis >7.45)

    • *Check CO2
    • <35-alkalosis, >45- acidosis

    • *Check HCO3
    • <22- acidosis, >26- alkalosis

    • *Check primary disorder (see chart)
    • *Compensation (see chart)

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