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What chemical buffer system within the body helps to maintain the pH relatively constant?
Carbonic Acid/ Bicarbonate Buffer system
What is the ratio of Bicarb (HCO3) to Carbonic Acid (H2CO3)?
20 bicarbonate:1 carbonic acid
Glucose & protein metabolism along with cell destruction, result in the production of?
How is Bicarbonate produced?
break down of carbonic acid, kidney and pancreatic production of bicarbonate, intestical absorption (antacids), and kidney reabsorption
When pH is decreased, the result is an acidotic state, how does the body react?
The respiratory system acts by allowing for deeper and more rapid breathing in an effort to blow off excess CO2
When pH is increased, the result is an alkalotic state, how does the body react?
The respiratory system acts by allowing for a decrease in rate and depth in an effort to hold onto CO2
Renal regulation is makes more permanent, long term changes? True or false?
when acidosis occurs and the renal system kicks into help, this __ is excreted in the urine?
- H+ is excreted in the urine
- bicarbonate is also reabsorbed and the kidneys begin to manufacture more bicarb
when alkalosis occurs and the renal system kicks into help, this __ is excreted in the urine?
HCO3 is excreted in the urine
The inability of the lungs to eliminate CO2 can result in what imbalance?
Respiratory acidosis results when lungs fail to expell CO2, the causes include?
- Inadequete chest expansion (skeletal deformaties, obesity, ascites)Respiratory Depression (opiods, trauma, neurological disease)Airway obstruction (Asthma, Cancer)Alveolar-Capillary block (ARDS, Embolus, Atelectasis)
Carbon Dioxide retention can result in?
This occurs when there is excessive acid production or inadequete bicarbonate production
Over production of H+ ions resulting in metabolic acidosis can occur as a result of?
DKA, fever, or seizure; starvation, aspirin overdose
Under elimination of H+ ions resulting in metabolic acidosis can occur as a result of?
Under production of bicarbonate resulting in metabolic acidosis can occur as a result of?
Renal Failure, pancreatitis, dehydration, or liver failure
Over elimination of bicarbonate resulting in metabolic acidosis can occur as a result of?
Clinical manifestation of acidosis include:
- Respiratory Acidosis
- decreased respiratory rateMetabolic Acidosis
- Kussmals in attempt to blow off CO2
The cardiac system can be affected by acidosis with the following clinical manifestations:
Dysrythmias (bradycardia to heart block), hypotension, weak pulses, wide QRS, prolong PR interval, prolonged T wave
The CNS can be affected by acidosis with the following clinical manifestations:
depression of the CNS can result in confusion and lethargy. Neuromuscular manifestations result from increase in H+ accompanied by hyperkalemia leading to decreased muscle tone and muscle weakness which is bilateral and can progress to flacid paralysis
The respiratory rate increases in an effort to blow off CO2 , this leads to increased gas exchange and affects the Integumentary system in what way?
- Metabolic Acidosis vasodilation causing the skin and mucus membranes to become warm, dry and pinkRespiratory ineffective breathing leads to hypoxemia and skin becomes pale to cyanotic, dry
Interventions for Acidosis:
- Treat underlying cause
- Metabolic Insulin and hydration are used to decrease blood glucose, therby stopping production of ketonesProlonged Diarrhea- antidiarrheals, and hydrationRenal Failure- dialysis to eliminate acid producing toxins and lower K+
Interventions for Respiratory Acidosis:
- Maintain patent airway with enhanced gas exchange
- -meds bronchodilator, steroids, mucolytics
- -oxygen improve gas exchange
- -pulmonary toilet
- -ventilatory support
- - frequent ABG reports
- Assess LOC frequently
- Diet- low carb, high fat limit additional acid production