Acid-Base Regulation And Imbalances (Nac1)

Front 1

A steady balance between acids and bases must be made to maintain what?

Back 1

homeostasis

Front 2

What are 3 examples of disorders that may lead to an acid-base imbalance?

Back 2

- diabetes mellitus
- vomiting and diarrhea
- respiratory conditions

Front 3

pH is a measure of what?

Back 3

hydrogen ion concentration

Front 4

pH ranges from ___ (acid) to ___ (base).

Back 4

1 to 14

Front 5

Blood is slightly ________ (acidic or alkaline).

Back 5

alkaline

Front 6

What is the normal pH range of blood?

Back 6

7.35-7.45

Front 7

A blood pH below 7.35 is acidosis. Would this indicate an increase or decrease of hydrogen concentration in the body?

Back 7

increase

Front 8

A blood pH above 7.45 is alkalosis. Would this indicate an increase or decrease of hydrogen concentration in the body?

Back 8

decrease

Front 9

What happens if a blood pH falls below 6.8 or above 7.8?

Back 9

death

Front 10

Metabolic processes in the body produce what as a byproduct of these actions?

Back 10

acids

Front 11

What must happen to the acids produced by metabolic processes?

Back 11

they must be neutralized and excreted

Front 12

What are 3 regulatory mechanisms that assist in maintaining blood pH?

Back 12

- buffers
- respiratory system
- renal system

Front 13

It take ___ components of a base to neutralize 1 acid in the body.

Back 13

20

Front 14

(def)

molecules in the body that act chemically to neutralize acids or change strong acids to weak acids

Back 14

buffers

Front 15

What are the primary regulators of the acid-base balance?

Back 15

buffers

Front 16

How long does it take for buffers to react to an acid-base imbalance?

Back 16

they have an immediate reaction

Front 17

True/False:

Buffers can maintain pH in the presence of respiratory or renal failure.

Back 17

False- buffers cannot maintain pH without adequate respiratory and renal function

Front 18

What are 5 examples of buffer systems in the body?

Back 18

1. phosphate buffer system (intracellular buffer system)
2. intracellular fluid (ICF)
3. protein buffer system
4. proteins in cells (ICF) and plasma (ECF)
5. hemoglobin buffer system

Front 19

The respiratory system eliminates what from the body?

Back 19

carbon dioxide

Front 20

What part of the brain controls breathing?

Back 20

respiratory center in the medulla

Front 21

The respiratory system responds how quickly to acid-base imbalances?

Back 21

withing minutes to hours

Front 22

Increased respirations lead to _______ (increased or decreased) carbon dioxide elimination.

Back 22

increased CO2 elimination

Front 23

Increased respirations lead to _______ (increased or decreased) carbon dioxide in the blood.

Back 23

decreased CO2 in the blood

Front 24

The renal system eliminates ________ and reabsorbs _________.

Back 24

eliminates hydrogen and reabsorbs bicarbonate

Front 25

How long does it take for the renal system to respond to acid-base abnormalities?

Back 25

hours to days

Front 26

The kidneys usually secrete acidic or alkaline urine? What is the average pH of urine?

Back 26

acidic with a pH around 6

Front 27

True/False:

The kidneys can increase or decrease pH as a compensatory mechanism.

Back 27

true

Front 28

When do imbalances in acid-base imbalances occur?

Back 28

when compensatory mechanisms in the body fail

Front 29

What are the 2 classifications of acid-base imbalances within the body?

Back 29

respiratory and metabolic

Front 30

Respiratory imbalances affect what?

Back 30

carbonic acid concentration

**carbonic acid is created when CO2 is dissolved in H2O, thus the relationship between CO2 balance and carbonic acid balance**

Front 31

Metabolic acid-base imbalances affect what?

Back 31

bicarbonate

Front 32

What does ABG stand for?

Back 32

Arterial Blood Gas

Front 33

What is the range of normal partial pressure of oxygen (paO2)?

Back 33

80-100

Front 34

What is the range of normal bicarbonate in the blood?

Back 34

22-26 mEq/L

Front 35

What is the range of normal partial pressure of carbon dioxide in the blood (paCO2)?

Back 35

35-45 mm Hg

Front 36

What is the normal oxygen saturation range of the blood?

Back 36

96-100%

Front 37

Carbonic acid excess can be caused by what 2 things?

Back 37

- hypoventilation
- respiratory failure

Front 38

How does the body compensate for carbonic acid excess in the body?

Back 38

- the kidneys conserve HCO3- and secrete H+ into the urine

Front 39

As O2 saturation levels go down in the body, _____ will decrease as well.

Back 39

paO2

Front 40

Carbonic acid excess is known as what?

Back 40

Respiratory acidosis

Front 41

A carbonic acid deficit is known as what?

Back 41

respiratory alkalosis

Front 42

What is the primary cause of a carbonic acid deficit?

Back 42

hyperventilation

Front 43

True/False:

Respiratory alkalosis is often caused by the aggressive treatment of disorders that cause hypoxemia.

Back 43

false- this rarely occurs

Front 44

A bicarbonate deficit is known as what?

Back 44

metabolic acidosis

Front 45

What are 6 causes of metabolic acidosis?

Back 45

- ketoacidosis
- lactic acid accumulation
- severe diarrhea
- kidney disease
- starvation
- renal failure

Front 46

The accumulation of lactic acid in the body is often seen in what disorder?

Back 46

shock

Front 47

Normal stool is ______ (alkaline or acidic)

Back 47

alkaline

Front 48

Metabolic acidosis is often seen in starvation due to what?

Back 48

the breakdown of stored fats and proteins and acid byproducts as a result of this breakdown

Front 49

Bicarbonate excess is known as what?

Back 49

metabolic alkalosis

Front 50

What are 5 causes of metabolic alkalosis?

Back 50

1. Prolonged vomiting
2. excessive gastric suctioning
3. diuretic therapy
4. potassium deficit
5. Gain of bicarbonate (antacids, sodium bicarbonate intake)

Front 51

What are 2 compensatory mechanisms to correct metabolic alkalosis?

Back 51

1. decreased respiratory rate to increase plasma CO2
2. Renal excretion of HCO3-

Front 52

What types of changes are seen in the neurological system with respiratory alkalosis? (3)

Back 52

- lethargy
- lightheadedness
- confusion

Front 53

What types of changes are seen in the cardiovascular system with respiratory alkalosis? (2)

Back 53

- tachycardia
- dysrhythmias

Front 54

What types of changes are seen in the GI system with respiratory alkalosis? (3)

Back 54

Nausea
Vomiting
Epigastric pain

Front 55

What types of changes are seen in the neuromuscular system with respiratory alkalosis? (5)

Back 55

- tetany
- numbness
- tingling of extremities
- hyperreflexia
- seizures

Front 56

What change is seen in the respiratory system with respiratory alkalosis?

Back 56

- hyperventilation (unless lungs are unable to compensate)

Front 57

What types of changes are seen in the neurological system with metabolic alkalosis? (3)

Back 57

- dizziness
- irritability
- nervousness/confusion

Front 58

What types of changes are seen in the cardiovascular system with metabolic alkalosis? (2)

Back 58

- tachycardia
- dsyrhythmias

Front 59

Dysrhythmias are seen with both respiratory and metabolic acidosis. What is the related to?

Back 59

Either hyper or hypokalemia. With a decrease in paCO2, you will see a decrease in potassium due to compensation. An increase in bicarbonate leads to an increase in potassium.

Front 60

What type of GI problems are associated with metabolic acidosis? (3)

Back 60

- nausea
- vomiting
- anorexia

Front 61

What type of neuromuscular problems are seen with metabolic alkalosis? (5)

Back 61

- tetany
- tremors
- tingling of fingers and toes
- muscle cramps
- seizures

Front 62

What type of respiratory problems are seen with metabolic alkalosis?

Back 62

- hypoventilation (compensatory mechanism of the lungs)

Front 63

The neuromuscular problems seen in both metabolic and respiratory alkalosis can be attributed to what?

Back 63

in both cases, alkalosis increases calcium binding to proteins in the body leading to a decrease in free calcium

Front 64

What type of neurologic problems are seen with respiratory acidosis? (5)

Back 64

- drowsiness
- disorientation
- dizziness
- headache
- coma

Front 65

What type of neurologic problems are seen with metabolic acidosis? (4)

Back 65

- drowsiness
- confusion
- headache
- coma

Front 66

What type of cardivascular problems are associated with respiratory acidosis? (3)

Back 66

- decreased BP
- ventricular fibrillation
- warm, flushed skin

Front 67

What type of cardiovascular problems are associated with metabolic acidosis?

Back 67

- decreased BP
- dysrhythmias
- warm, flushed skin

Front 68

What type of GI problems are associated with metabolic acidosis? (4)

Back 68

- nausea
- vomiting
- diarrhea
- abdominal pain

Front 69

What type of neuromuscular problem is seen with respiratory acidosis?

Back 69

seizure

Front 70

What type of respiratory problem is seen with respiratory acidosis?

Back 70

hypoventilation with hypoxia

Front 71

What type of respiratory problem in seen with metabolic acidosis?

Back 71

deep, rapid respirations

Front 72

Alkalosis is characterized by low _____ and high _____.

Back 72

Low PaCO2
High HCO3-

Front 73

Acidosis is characterized by high ____ and low ____.

Back 73

High PaCO2
Low HCO3-

Front 74

ABG values provide information about what 4 things?

Back 74

1. acid-base status
2. underlying cause of the imbalance
3. body's ability to regulate pH
4. overall oxygen status

Front 75

If pH and pCO2 have moved in the opposite direction, there is a _______ problem.

Back 75

respiratory

Front 76

If pH and HCO3- have moved in the same direction, there is a _______ problem.

Back 76

metabolic

Front 77

If the paCO2 and HCO3- have moved in the same direction, what is the body doing?

Back 77

compensating for an abnormal pH

Front 78

If paCO2 and HCO3- have moved in the same direction but pH is still out of range, we say that this is what?

Back 78

partially compensated

Front 79

If paCO2 and HCO3- have moved in the same direction and pH is within normal range, we say that this is what?

Back 79

fully compensated

Front 80

What does the mnemonic ROME stand for?

Back 80

Respiratory Opposite Metabolic Equal

Front 81

What is this?

pH= 7.26
PaCO2= 42
HCO3-= 17

Back 81

Acute Metabolic Acidosis

Front 82

What is this?

pH= 7.49
PaCO2= 30
HCO3-=23

Back 82

Acute Respiratory Alkalosis

Front 83

What is this?

pH= 7.26
PaCO2= 52
HCO3-= 34

Back 83

Partially Compensated Respiratory Acidosis

Front 84

What is this?

pH= 7.36
PaCO2= 50
HCO3-= 34

Back 84

Fully Compensated (Chronic) Respiratory Acidosis

Front 85

What is this?

pH= 7.43
PaCO2= 49
HCO3-= 30

Back 85

Chronic Metabolic Alkalosis

Front 86

What is this?

pH= 7.36
PaCO2= 67
HCO3= 37
PaO2= 47

Back 86

Fully Compensated (chronic) Respiratory Acidosis with severe hypoxemia