Acid Base & Respiratory

Front 1

Respiratory center is located where?

Back 1

medulla oblongata

Front 2

What do the chemoreceptors in the medulla oblongata respond too chemical change wise?

Back 2

PaCo2 and H+ (responds within minutes to hours following changes)

Front 3

Increased H+ causes pH to do what and leads too what?

Back 3

pH drops, causes acidosis

Front 4

Decreased H+ causes pH to do what and leads too what?

Back 4

pH increases, causes alkolosis

Front 5

What are normal ABG lab values?

Back 5

pH 7.35-7.45
PaCo2 35-45
PaO2 80-100
HCO3 21-28
O2 Sat % >92%

Front 6

Gas exchange is dependent on the presence of what in the blood?

Back 6

Hgb

Front 7

How much of the 02 is carried by Hgb in the blood?

Back 7

97%

Front 8

Respiration consists of the ____ of 02 across the ______-____ membrane into the _________ circulation.

Back 8

a) diffusion
b) aveolar-capillary
c) pulmonary

Front 9

With the chloride shift if Cl moves into the red blood cells in response to the amount of 02 and acid what moves out?

Back 9

HC03

Front 10

True or false

Buffers can maintain pH with impairment of respiratory and renal systems due to diffusion and osmosis of electrolytes within the body.

Back 10

False- buffers require respiratory and renal systems adequate functioning to maintain pH

Front 11

What happens with increased H+ concentration in regards to the respiratory system?

Back 11

Acidosis causes medulla to increase respirations to blow off Co2

Front 12

What happens with decreased H+ concentration in regards to the respiratory system?

Back 12

Alkolosis causes medulla to decrease respirations to retain or decrease loss of Co2

Front 13

What three things is the brain sensitive to changes ?

Back 13

o2, H+, glucose

Front 14

What three mechanisms do the kidneys use to eliminate acid?

Back 14

1) secrete H+ into renal tubules

2) excrete weak acids

3) Combinatoon of H+ with ammonia to form ammonia (NH3)

Front 15

How long does the renal system take to respond to changes in acid base?

Back 15

Hours to days.

Front 16

True or false

If renal failure is the cause of acid base imbalance it retains the ability to correct pH alterations?

Back 16

False

Front 17

base excess indicates what in regards to acid base?

Back 17

The amount of excess or insufficient level of HCO3 in the system (-2 to +2 mEq/L)

Front 18

In regards to classification of acid base imbalances, what function is affected by carbonic acid concentration?

Back 18

Respiratory

Front 19

In regards to classification of acid base imbalances, what function is affected by bicarbonate concentration?

Back 19

Metabolic

Front 20

With respiratory acidosis carbonic acid excess can be caused by?

Back 20

Hypoventilation, CNS depression, Loss of lung surface, respiratory failure (pneumonia)

Front 21

With respiratory acidosis how do kidneys compensate?

Back 21

They conserve HCO3 and secete H+ into urine.

Front 22

With respiratory alkolosis some causes are?

Back 22

Hyperventilation, Hypoxemia from acute pulm disorders, fever, pain, CNS problems.

Front 23

Metabolic acidosis occurs by base HCo3 deficit caused by what conditions?

Back 23

Ketoacidosis, lactic acid accumulation, severe diarrhea, kidney disease.

Front 24

Compensatory reaction of metabolic acidosis by renal and respiratory systems are what?

Back 24

Increased Co2 excretion by the lungs via Kussmaul breathing (deep & rapid)

kidneys excrete acid

Front 25

Metabolic alkalosis occurs by base HCo3 excess caused by what?

Back 25

Prolonged vomiting, loss of acids, gain of HCO3

Front 26

Metabolic alkalosis compensatory reactions by the renal and respiratory systems are what?

Back 26

Decreased RR to retain Co2

Renal excretion of HCO3 is increased

Front 27

The following refers to what term?

Movement of air into and out of the lungs. (inspiration/expiration)

Back 27

Ventilation

Front 28

The following refers to what term?

Measure of the ease of expansion of the lungs

Back 28

Compliance

Front 29

The following refers to what term?

Movement from an area of higher concentration to that of lower concentration

Back 29

Diffusion

Front 30

The following refers to what term?

The cilia of the respiratory epithelium beat in concert cranially, effectively moving secreted mucus containing trapped foreign particles toward the oropharynx, for either expectoration or swallowing to the stomach where the acidic pH helps to neutralize foreign material and micro-organisms.

Back 30

Mucociliary escalator

Front 31

The following refers to what term?

Protective reflex action that clears the airway by high pressure, high velocity of air.

Back 31

cough reflex

Front 32

The following refers to what term?

Defense mechanism in response to the inhalation of large amounts of irritating substances.

Back 32

reflex broncoconstriction

Front 33

The following refers to what term?

Defense of the alveolar level, these phagocytize inhaled foreign particles such as bacteria.

Back 33

alveolar macrophages

Front 34

The following refers to what term?

The affinity of Hgb for O2, represented by a graph that shows the percent of saturation of Hgb at various partial pressures of oxygen

Back 34

02-Hgb dissociation curve

Front 35

If the 02-Hgb shifts to the left what occurs?

This is demonstrated in what conditions?

Back 35

a) Blood oicks up 02 more readily in the lungs but delivers it less readily in the tissues.

b) Alkalosis, hypothermia, decrease in partial pressure of Co2 in arterial blood.

Front 36

If the 02-Hgb shifts to the left due to hypothermia what is one thing that may be done to correct it?

Back 36

Increase oxygen oncentration being delivered until body temp normalizes

Front 37

Gerontologic effects due to aging on the respiratory system are what?

Back 37

Decreased compliance, eslasticity and total lung capacity.

Decreased cough reflex, cilia, moisture in mucus membranes.

Decreased lung expansion, immune system.

Gastric reflux may cause aspiration.

Front 38

What function does the nasal cavity have in regards to respiratory?

Back 38

Warming, filtering & humidifying the blood.

Front 39

What function does the epiglotis have in regards to respiratory?

Back 39

helps prevent aspiration

Front 40

Where does the trachea bifurcate?

Back 40

Carina

Front 41

Obvious S/S of respiratory distress include what?

Back 41

Tachypnea, Use of accessory muscles, skin color, appearance and LOC, RR (depth, rhythm, & pattern)

Front 42

What breath sounds are heard over trachea?

Back 42

Bronchial

Front 43

What breath sounds are heard over main bronchi?

Back 43

bronchiovesicular

Front 44

What breath sounds are heard over lesser bronchi, bronchioles, and lobes?

Back 44

vesicular

Front 45

Cues of early respiratory/hypoxia distress problems?

Back 45

restlessness, anxious, dyspnea, SoB, tachycardia, mild htn, wheezing.

Front 46

Cues of early/late respiratory/hypoxia distress problems?

Back 46

confusion, arrhythmias, diaphoresis, unexplained fatigue, decreased urine output.