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62 Cards in this Set
- Front
- Back
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Acid-base homeostasis |
Acid producing, acid buffering, acid excretion |
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Acid |
Substances that release hydrogen when dissolved in water Fats form fatty acids, proteins form amino acids |
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Bases |
Substances that bind hydrogen ions when in water |
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pH |
The measure of acidity or alkalinity due to the concentration of hydrogen ions (H+) in body fluid |
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Alkaline solution |
Higher pH less amount of H+ ions |
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Acid solution |
Lower the pH the greater amount of H+ |
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Blood pH |
7.35-7.45 |
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Urine pH |
4.6-8.0 |
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Alkalosis |
Blood pH is >7.45 |
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Acidosis |
Blood pH is <7.35 |
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Bicarbonate buffer system (chemical regulator) |
-first line of defense against a change in pH -maintains the acid base balance 50% of the time -acts instantaneously but can’t maintain balance for long -acts with acids or bases to prevent significant changes in patients pH |
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Bicarbonate in ECF & ICF |
-act primarily in ECF -common buffers -given IV during emergencies -acts instantaneously -normally bicarbonate base HCO3:: carbonic acid H2CO3 = 20::1 |
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Phosphate buffers in ICF |
-control small fluctuations in pH -responds quickly |
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Protein found in ICF (hemoglobin) and ECF (albumin) |
-responds quickly -most plentiful and most powerful of the buffer -act as acid or base as the occasion demand |
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Respiratory regulation |
-second line of defense -reacts within minutes to hour to blood pH -come to the rescue when fluctuations are acute and chemical buffers are no longer doing -regulates carbonic level by altering rate and death of respiration’s *if excess acid= ^ resp. rate to blow off excess co2 and water vapor *if excess base= decreased resp rate to retain co2 which combines with water to form carbonic acid |
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Renal regulatjon |
-third line of defense, most powerful mechanisms for regulating -takes a longer time to begin: slowest of the regulating systems (takes hours to days) -regulates by altering the rate of H+ or bicarb ion excretion -alkalosis: retains H+ excretes bicarb// acidosis: retains bicarbs, excretes H+ -eliminations metabolic acids (lactic acid), regulates PH+, forms ammonium salts -three major renal mechanisms; tubular kidney movement of bicarbonate, kidney tubule formation of acids, formation of ammonium from amino acid catabolism |
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Arterial blood gas |
Blood gas measurements remain the major diagnostic tool for evaluating acid-base status |
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pH value |
Acidosis <7.35-7.45>alkalosis Measures blood acidity, concentration of H+ ions, indicates acid base balance |
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paCO2 value |
Alkalosis<35-45mmHg>acidosis Measures partial pressure of CO2 |
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pa02 value |
Acidosis<80-100mmHg>alkalosis Measure partial pressure of O2 in arterial blood Indicates level of oxygenation of the cardiopulmonary systems |
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HCO3 (bicarb) value |
Acidosis<22-26mEq/L>alkalosis Measures the amount of bicarbonate in the arterial blood Indicates level of kidney function Major factor in metabolic acid-base balance |
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O2 saturation |
95% or higher The oxygen saturation of available Hemoglobin Not a reliable indicator, too many variables |
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Nursing interventions for acid-base imbalances |
1. Monitor and assess patients for risks, s/sx and causes 2. Monitor ABG and lab results as ordered and report abnormalities 3. Monitor and assess vital signs, respiratory, cardiac and neurological status |
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Respiratory acidosis |
Back (Definition) |
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Respiratory alkalosis |
Back (Definition) |
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Metabolic acidosis |
Back (Definition) |
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Metabolic alkalosis |
Back (Definition) |
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Acid base imbalances |
Back (Definition) |
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Oxygenation |
Delivery of oxygen from lungs, to heart, and rest of the body Delivery of deoxygenated blood from body to heart and pulmonary circulation Function of both respiratory/CV systems to supply body’s oxygen demand |
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Ventilation |
Process of moving gases into and out of the lungs |
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Tissue perfusion |
Ability to the cardiovascular system to pump oxygenated blood to the issues and returned deoxygenated blood to the lungs |
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Diffusjon |
The spreading of something widely |
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Diffusion |
The spreading of something widely |
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Inspiration |
ACTIVE process, stimulated by chemical receptors |
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Expiratjon |
PASSIVE process that depends on the elastic recoil properties of lungs, requiring little to no muscle work |
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Surfactant |
Chemical produced in the lungs to maintain the surface tension of the alveoli and keep from collapsing |
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Atelctasis |
Collapsed lung |
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Accessory muscles |
Increased lung volume during inspiration |
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Compliance |
Ability of the lungs to distend or expand in response to increased intra-alveolar pressure |
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Airway resistance |
Increased in pressure that occurs as the diameter of the airways decrease from mouth/nose to alveoli |
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Tidal volume |
Amount of air exhaled following a normal inspiration |
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Residual volume |
Amount of air left in the alveoli after a full expiration |
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Forced vital capacity |
Maximum amount of air that can be removed from the lungs during forced expiratjon |
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Oxygen transport |
Consists of the lungs and cardiovascular |
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Regulation of respiration |
Ensures sufficient O2 intake and CO2 elimination to meet the demands of the body Neural/chemical regulators control the process of respiration |
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Hypovolemia |
Extracellular fluid loss and reduced circulating blood volume - shock and severe dehydration |
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Decreased inspired oxygen concenration |
Decline of the concentration of inspired O2 and the O2 carrying capacity of the blood decreases |
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Increased metabolic rate |
IncreasesO2 demand |
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Conditions affecting chest wall movement -Pregnancy- |
As the fetus grows, the enlarging uterus pushes abdomen contents up against the diaphragm |
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Obesity |
Have reduced lung volumes from the heavy lower thorax/abdomen mostly in recumbent and supine positions |
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MS abnormalities |
Impaired the thoracic region reducing O2 ex: kyphosis, poor posture/body alignment |
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Trauma |
Unstable chest wall allows the lung under injury to contract on inspiration and bulge on expiration=hypoxia |
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Neuromuscular/diseases |
Affect tissue oxygenation by decreasing a patients ability to expand/contract the chest wall |
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CNS alterations |
Any disease medulla/spinal cord results in impaired respiration ex: narcos, sedatives, anti anxirty |
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Risk factors for infants/toddlers |
^ risk for ^ respiration infections, immature system, second hand smoke and aspiration with small toys |
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Risk factors young and middle adults |
Exposed to unhealthy diet, lack of exercise, over the counter and prescription drugs, smoking |
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Risk factors for older adults |
Cardiac/respiration systems change, calcification of heart valves, SA node, and coastal cartilage, decreased alveoli, cough reflex, airway reflexes, mobility and lunch expansion |
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Lifestyle factors- nutrition |
Amount of protein and fluid intake Malnourished- low hemoglobin, iron and protein |
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Lifestyle factors- exeecise |
Active or sedated- Less able to respond to stressors |
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Lifestyle factors- smoking |
Decreased or paralyzed cilia, increased sputum and risk for bronchi spasms, 10x risk for cancer |
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Substance anuse |
Alcohol decreased depressed respiratory efforts, risk for aspiration with vomiting |
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Lifestyle factors- stress |
Depression decreases everything, anxiety increases everything |
