Adult I Acid Base Balance

Front 1

What is normal blood pH

Back 1

7.35 to 7.45

Front 2

What will changes in blood pH outside of normal range cause

Back 2

hormone and enzyme fluctuation alterations, fluid and electrolyte disturbances, membrane excitability, decreased uptake, absorption, distribution and effectiveness of many drugs and hormones

Front 3

What are acids

Back 3

substances that release a hydrogen ion when teh substance is dissolved in water

Front 4

What determines the strength of an acid

Back 4

how easily the hydrogen ions is released

Front 5

What is a substance that binds free hydrogen ions in solution

Back 5

base

Front 6

What is a substance that releases a hydrogen ion when the substance is dissolved in water

Back 6

acid

Front 7

What do strong bases do?

Back 7

bind hydrogen ions easily

Front 8

What do buffers do?

Back 8

either release a hydrogen ion into a fluid or bind a hydrogen ion from a fluid

Front 9

What are some sources of acids

Back 9

glucose metabolism, metabolism of fats and proteins, anaerobic metabolism, destruction of cells

Front 10

What are some sources of bicarbonate

Back 10

carbonic acid breakdown, intestinal absorption, pancreatic production, movement of intracellular bicar into extracellular, kidney reabsorption

Front 11

What are some acid base regulating mechanisms?

Back 11

chemical, respoiratory, renal, compensation

Front 12

What are the 2 most common chemical buffers?

Back 12

bicarb buffers in extracellular fluid, phosphate in the intracellular fluid

Front 13

What are the largest source of buffers

Back 13

proteins

Front 14

What is the major cellular protein buffer

Back 14

hemoglobin

Front 15

What are the 2 respiratory mechanisms to balance acid base balance

Back 15

hyperventilation and hypoventilation

Front 16

What are the renal mechanisms to balance the acid base balance

Back 16

kidney movement of bicarb, formation of acids, formation of ammonium

Front 17

What can the lungs compensate for

Back 17

changes in metabolic disturbances

Front 18

What can the renal system compensate for

Back 18

an imbalance in the respiratory system or if the origin is metabolic

Front 19

What are some parts of physical assessment for acid base balance

Back 19

alert, moist mucous membranes, urine output and fluid intake are equal, good skin turgor, ABGs, BUN, creatinine, glucose, osmolartiy

Front 20

What is H model

Back 20

left axis (PaCo2) and the right axis (HCO3) and then use that to determine imbalance

Front 21

What are some causes of metabolic acidosis?

Back 21

overproduction of hydrogen ions; excess breakdown of fatty acids (DKA or starvation), hypermetabolism (anaerobic lactic acidosis), strenuous exercise, fever, seizures, tissue hypoxia, excessive intake of acidic substances (alcohol, methyl alcohol, acetylsalicylic acid)

Front 22

What are some other causes of metabolic acidosis?

Back 22

underelimination of H+ ions (kidney failure), underproduction of bicarb (reduced organ function), overelimination of bicar (diarrhea)

Front 23

What are some lab asessements of metabolic acidosis?

Back 23

decreased pH, decreased bicarb levels, noremal PaCo2 or carbon dioxide, elevated serum K+, normal or elevated chloride level

Front 24

What are some interventiosn for metabolic acidosis?

Back 24

hydration and meds to treat underlying cause of acidosis

Front 25

What is the cause of respiratory acidosis?

Back 25

impairment of any fucntion that causes inadqueate exchange of O2

Front 26

What are some causes of respiratory acidosis?

Back 26

chemical or physical respiratory depression, flail chest or broken ribs, respiratory muscles weakness, non respiratory conditions

Front 27

How many airway obstruction cause respiratory acidosis?

Back 27

restrictive clothing, edema, local lymph node enlargement, aspiration of foreing objects, internal obstruction of smooth muscle, excessive mucous, asthma, broncholitis, emphysema, decreased alveolar diffusion (pneumonia, TB, chest trauma)

Front 28

What are some lab assessments for respiratory acidosis?

Back 28

decreased pH, elevated paco2, low pa02, elevated serium potassium, variable bicar levels

Front 29

What are some interventions for respiratory acidosis?

Back 29

maintain patent airway and enhance gas exchange, drug therapy, oxygen therapy, pulmonary hygiene, ventilatory support and maintenance, prevention of complications

Front 30

What may acidosis cause that is serious?

Back 30

elevated serum potassium!!!!

Front 31

What may cause acid deficit or metabolic alkalosis?

Back 31

prolonged vomiting, Cushings syndrome, hyperaldosteronism, thiazide diurectics, prolonged NG suctioning

Front 32

What may cause base excess or metabolic alkalosis?

Back 32

overuse of antacids, citrate excess from massive or rapid blood transfusions, hyperalimentation, bicarb overcorrection

Front 33

What are some lab assessments for metabolic alkalosis?

Back 33

pH above 7.45, elevated bicar level (above 28), rising partial pressure of PaCo2, normal PaO2, decreased serum K+, decreased serum Calcium

Front 34

WHat are some interventions fo metabolic alkalosis?

Back 34

plan to prevent further loss of hydrogen, potassium, calcium, and chloride ions, drugs to resolve present imbalances, careful titration of fluids to maintain and prevent imbalance, monitor ABG

Front 35

What is a cause of respiratory alkalosis

Back 35

hyperventilation

Front 36

What are some lab assessments of respiratory alkalosis

Back 36

ph above 7.45, low bicarb level, low PaCo2, decreased serum potassium, decreased serum calcium

Front 37

What are some interventions for respiratory alkalosis?

Back 37

monitor ABGs, monitor for respiratory failure, hyperventilation, utilize O2 therapy, ventilator support as needed