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28 Cards in this Set

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Acid
A substance that can donate H+
Acidosis
•< 7.35
•H+ Excess
•HCO3 Deficit
Alkalosis
•> 7.45
•H+ Deficit
•HCO3 Excess
Base
A substance that can accept H+
Bicarbonate-Carbonic Acid Buffering system
•Most important ECF buffering system
•HCO3 + H+ => H2CO3 => H20 + CO2 breathe out
Buffering anions
HCO3 major also hemoglobin, phosphate, and proteins
Carbonic Acid (H2CO3)
Unable to measure directly
Dissolves in plasma to form CO2 +H20
eliminated by lungs
Use co2 to measure acid component
Causes of Metabolic Acidosis
Cardiac Arrest, Shock, Diabetic Ketoacidosis, Fasting/starvation/malnutrition, Ketogenic diet, Aspirin Toxicity, Renal Failure, Severe Diarrhea, Hyperchloremia
Causes of Metabolic Alkalosis
Excess NaHCO3 intake, prolonged vomiting/bingeing/purging, GI suction, Diuretics, Hyperaldosteronism, Renal Failure
Causes of Respiratory Acidosis
HYPOVENTILATION:
COPD, Drug overdose, Head injury, respiratory muscle disorders
Causes of Respiratory Alkalosis
HYPERVENTILATION:
Panic attacks, hypoxia, Fever, Saliclate Toxicity, Mechanical Ventilation
Exchange between H+ & K+ Buffering System
•Acidosis => H+ moves into ICF K+ moves into ECF

•Alkalosis => H+ moves into ECF K+ moves into ICF
CO2
used to express Carbonic acid
Although CO2 is not an acid (has no H+ to donate), but because of its relationship with H2CO3, it is referred to as an acid
Kidney Regulation of pH
Retain or excrete HCO3 or H+ as needed
Kidneys compensate slowly but provide complete compensation
Acidosis (↓ pH)
•Retain HCO3 or Excrete H+
Alkalosis (↑ pH)
•Excrete HCO3 or Retain H+
Metabolic Acidosis
↓Bicarbonate (HCO3) <21 mEq/L
↓pH
Resp. Comp: Hyperventalation to ↓ PCO2
Renal Comp: if no renal disease, ↑ H+ excretion and ↑ HCO3 Reabsorption
-BE
Metabolic Alkalosis
↑HCO3 >28 mEq/L
↑pH
Resp. Comp: Hypoventalation to ↑PCO2
Renal Comp: If no renal disease ↓H+ excretion and ↓ HCO3 reabsorption
+ BE
mild hypoxemia
60-80 mm Hg PO2
Mod. Hypoxemia
PO2: 45-60 mm Hg
Noncompensation
pH is abnormal
PCO2 or HCO3 OR Abnormal
Partial Compensation
pH is abnormal
both PCO2 AND HCO3 are abnormal
PCO2
In acid-base terminology, CO2 is expressed as PCO2
P = Partial Pressure
Refers to the pressure / tension exerted by this gas in blood
Partial Pressure = because CO2 is only one of several gases contributing to the total pressure (Oxygen, Nitrogen & Other Gases
pH ratio and what is it determined by?
•Determined by ratio of bicarb & carbonic acid
•pH maintained by a ratio of 20:1 (bicarb:CA)
Primary Disturbance
match between pH and PCO2
Respiratory system causing primary disturbance
Primary Disturbance:
Match between pH and HCO3
Metabolic system causing primary disturbance
Respiratory Acidosis
↑ PCO2 (>45mm Hg)
↓pH
Renal Comp:↑H+ excretion and ↑HCO3 reabsorption
Respiratory Alkalosis
↓PCO2 (<35mm Hg)
↑pH
Renal Comp: ↓H+ excretion and ↓ HCO3 reabsorption
Respiratory Regulation of pH
Lungs regulate carbonic acid (H2CO3) by ↑ ↓ Respirations
Lungs compensate quickly but incompletely
Acidosis (↓ pH)
•↑ RR => Blow off CO2 + H20
Alkalosis (↑ pH)
•↓ RR => Retain CO2 + H2O
Severe Hypoxemia
PO2: < 45 mm Hg