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32 Cards in this Set
- Front
- Back
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normal pH
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pH 7.35-7.45
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most common buffer system
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CO2 + H2O --- H2CO3 --- H+ + HCO3-
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normal ratio of carbonic acid to bicarbonate
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1:20
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respiratory acidosis
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Increased CO2 results in decrease in pH
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respiratory alkalosis
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Decreased CO2 results in increase in pH
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respiratory component of acid-base balance
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CO2 (carbon dioxide)
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metabolic acidosis
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Increased HCO3 results in increase in pH
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metabolic alkalosis
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Decreased HCO3 results in decrease in pH
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metabolic component of acid-base balance
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HCO3 (bicarbonate)
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normal PaCO2
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35-45 mmHg
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normal PaO2
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83-100 mmHg
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normal HCO3
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22-26 mEq/L
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ABG analysis step 1
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if pH is <7.35, acidosis
if pH is >7.45, alkalosis |
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ABG analysis step 2
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if CO2 is abnormal, respiratory
if HCO3 is abornmal, metabolic |
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ABG analysis step 3
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pH is normal: fully compensated
pH & opposite number out of range: partially compensated pH out of normal range, opposite number in normal range: no compensation |
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oxyhemoglobin curve
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changes in pH alter ease with with hemoglobin releases O2 to plasma
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values of metabolic acidosis
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pH is low, HCO3 is low
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values of metabolic alkalosis
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pH is high, HCO3 is high
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values of respiratory acidosis
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pH is low, PaCO2 is high
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values of respiratory alkalosis
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pH is high, PaCO2 is low
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causes of metabolic acidosis
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diabetic ketoacidosis, starvation, lactic acidosis, excess ETOH or ASA, renal failure, diarrhea
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s/s of metabolic acidosis
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lethargy, confusion, stupor, coma, hyporeflexia, muscle weakness, bradycardia, thready pulses, low BP, Kussmaul resp, warm/flushed/dry skin, hyperkalemia
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treatment of metabolic acidosis
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treat the cause: insulin, hydration/electrolytes, antidiarrheals, sodium bicarbonate, dialysis
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causes of metabolic alkalosis
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antacid overuse, IV LR overuse, NaHCO3 overuse, vomiting, NG suctioning, thiazide diuretics
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s/s of metabolic alkalosis
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anxiety, irritability, hyperreflexia, muscle cramps/weakness, tachycardia, normal or low BP, shallow resps, hypokalemia, hypocalcemia
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treatment of metabolic alkalosis
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treat the cause: fluid/electrolyte replacement, NS IV, Ca++, K-sparing diuretics, antiemetics
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causes of respiratory acidosis
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head injury, Rx overdose, chest injury, electrolyte imbalance, severe obesity, ascites, hemothorax, COPD, aspiration, pneumonia, pulm edema, TB, PE
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s/s of respiratory acidosis
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skin pale to cyanotic & dry, incr. PaCO2
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treatment of respiratory acidosis
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increase CO2 excretion: bronchodilators, steroids, Mucomyst, O2, pulmonary hygiene, PAP
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causes of respiratory alkalosis
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hyperventilation - anxiety, fear, mechanical ventilation; hypoxemia - asphyxiation, shock, high altitude
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s/s of respiratory alkalosis
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numbness & tingling around mouth, extremities, resp. effort normal or incr.
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treatment of respiratory alkalosis
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treat underlying condition, support renal function w/ fluids, breath into bag or rebreather, sedatives
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