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47 Cards in this Set
- Front
- Back
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normal pH |
7.35-7.45 (7 is neutral) |
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the body maintains a narrow pH range by 3 mechanisms |
chemical buffers CO2 elimination HCO3 elimination |
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chemical buffers |
(extracellular and intracellular) react instantly to compensate for the addition or subtraction of H+ ions |
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CO2 elimination |
is controlled by the lungs (respiratory system). Decreases (increases) in pH result in decreases (increases) in PCO2 within minutes |
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HCO3 elimination |
is controlled by the kidneys. Decreases (increases) in pH result in increases (decreases) in HCO3. it takes hours to days for the renal system to compensate for changes in pH |
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COPD chronic vomiting anxiety diabetic ketoacidosis drug overdose early chf pulmonary embolism hypokalemia
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Respiratory Acidosis Metabolic alkalosis respiratory alkalosis metabolic acidosis respiratory acidosis respiratory alkalosis respiratory alkalosis metabolic alkalosis
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pulmonary embolus hypotension vomiting severe diarrhea cirrhosis (late stage of scarring of liver) renal failure sepsis pregnancy diuretic use COPD |
respiratory alkalosis metabolic acidosis metabolic alkalosis metabolic acidosis respiratory alkalosis metabolic acidosis respiratory alkalosis/metabolic acidosis respiratory alkalosis metabolic alkalosis respiratory acidosis |
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normal values of (arterial) PaCO2 HCO3 PaO2 O2 sat |
35-35 22-26 95-100 >95% |
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acids bases |
release hydrogen ions accept hydrogen ions |
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Arterial Blood Gas (ABG) are used to measure what |
ventilation perfusion and diffusion |
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ventilation |
how well air is flowing in and out of lungs |
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perfusion |
blood flow to the lungs (cardiac output) |
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diffusion |
how well O2 and CO2 are being exchanged through the alveolar capillary membrane |
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acidosis (ph < 7.35) alkalosis (ph >7.45) |
increase in hydrogen = decrease in ph decrease in hydrogen = increase in ph |
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acidosis or alkalosis (pH) 7.41 7.32 7.29 7.49 7.38 7.53 |
normal acidosis acidosis alkalosis normal alkalosis |
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PCO2 |
refers to the pressure or tension exerted by CO2 in the blood a measure of the depth of pulmonary ventilation |
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hypoventilation PCO2 > ? causes ? |
inadequate ventilation >45 acidosis |
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hyperventilation PCO2 < ? causes ? |
excessive ventilation <35 alkalosis |
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hyperventilation or hypoventilation (PCO2) 33 35 50 40 47 |
hyperventilation normal hypoventilation normal hypoventilation |
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respiratory acidosis pH <? PCO2 >? increase in what lowers pH |
CO2 production is greater than CO2 removal (excessive carbonic acid) 7.35 45 PCO2 |
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Respiratory acidosis etiology |
emphysema, copd, depression of respiratory center, neuromuscular disorders |
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emphysema |
air trapping and bronchitis |
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COPD |
cannot exhale CO2 (can breathe in but have trouble exhaling) |
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depression of respiratory center |
over sedation overdose |
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neuromuscular disorders guillan/barre myasthenia gravis
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damage to phrenic nerve and diaphragm unable to move air need to be on ventilator muscle weakness |
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diffusion defects |
pulmonary edema atelectasis (alveolar collapse) |
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clinical manifestations of respiratory acidosis |
sensorium changes (dizziness, confusion) cyanosis or flushed headache dysrhythmias |
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treatment of respiratory acidosis |
improve ventilation pharmacologic measures (bronchodilators) pulmonary hygiene (coughing, suctioning, deep breathe, turning, sitting up) oxygen administration |
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Nursing implications of respiratory acidosis |
assess symptoms and cause assess RR, SpO2, SOB maintain patent airway |
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respiratory alkalosis pH >? and PCO2 <? |
7.45 35 |
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Respiratory alkalosis etiology |
anxiety hypoxemia high fever sepsis |
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clinical manifestations |
tachypnea light headed hyperventilation syndrome (tingling in extremities, numbness, dry mouth) |
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Respiratory alkalosis or acidosis 7.32 and 60 7.50 and 30 7.41 and 39 7.51 and 28 7.30 and 58 7.31 and 31 |
respiratory acidosis respiratory alkalosis normal respiratory alkalosis respiratory acidosis neither |
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Bicarbonate (HCO3) |
excreted by the kidneys influenced by metabolic processes (non respiratory) processes occurs lower than the respiratory component |
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metabolic acidosis ph < ? and HCO3 <? |
kidney excretes too much bicarbonate or too much acid is accumulated in the body deficit in bicarbonate ion 7.35 and 22 |
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causes of metabolic acidosis |
diabetic ketoacidosis renal failure lactic acidosis diarrhea poisoning |
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diabetic ketoacidosis |
glucose cant get to cells to break down CHO, instead fats are broken down, byproduct is ketones (acids) |
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renal failure |
kidneys cant reabsorb bicarbonate |
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lactic acidosis |
decreased oxygen body goes from anaerobic metabolism (byproduct is O2 and CO2) to aerobic meta (byproduct -lactic acid) lactic acid accumulates in the body |
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diarrhea |
loss of alkaline secretions |
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poisoning |
salicyclic acid |
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clinical manifestations of metabolic acidosis |
headache, GI upset, confusion, hyperkalemia (K exits cell in exchange for H and increases serum K) |
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treatment DKA, Renal failure |
insulin bicarbonate |
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Metabolic alkalosis ph and HCO3 |
>7.45 and >26 |
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etiology of metabolic alkalosis |
gastric losses (vomiting, NG tube) hypokalemia (K exchanges for H and goes into the cell decreasing serum K) |
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clinical manifestations |
GI upset, tremors, dizziness |
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Metabolic acidosis or alkalosis (ph and HCO3) 7.41and 23 7.51 and 30 7.31 and 19 7.34 and 20 7.33 and 50 7.50 and 50 |
normal metabolic alkalosis metabolic acidosis metabolic acidosis neither metabolic alkalosis |
