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30 Cards in this Set
- Front
- Back
What are the normal lab values?
-pH -CO2 -HCO3 -O2 |
-ph: 7.35-7.45 (<7.35=acidosis, >7.45=alkalosis)
-CO2: 35-45 mm/Hg -HCO3: 22-26 mEq/L -O2: 80-100 mm/Hg |
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Acid
Acidosis |
-substances that release H+ ions
-increase in H+ or decrease in HCO3 |
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What is an acidosis?
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An acidosis is the result of any process in which acids accumulate (or base is lost) in greater than normal amounts
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Base
Alkalosis |
-substances that accept H+ ions
-decrease in H+ or increase in HCO3 |
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What is an alkalosis?
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An alkalosis is the result of any process that, by itself, increases base or in which acid is lost in greater than normal amounts
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Normal pH level
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-normal pH= 7.35-7.45
*7.35-7.4=normal, slightly acidic *7.4-7.45=normal, slightly alkaline |
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What are buffer systems?
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-they want to keep pH in the normal range (7.35-7.45)
-chemicals that react to minimize pH changes -absorb excessive acid or base |
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-CO2 is a ____ cause
-HCO3 is a _____ cause |
-CO2=respiratory cause
-HCO3=metabolic cause |
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Carbonic acid - bicarbonate buffering system
-CO2 and H2O <--> H2CO3 <-->H+ and HCO3 -too much acid? -too much base? |
-too much acid: H+ and HCO3. Forms CO2 that you breath out
-too much base: H2CO3-->H+ and HCO3 (lowers pH) |
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-Renal regulation (kidneys) takes how long?
-what levels does it involve? |
-Takes hours or days
-HCO3 value and H levels |
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Renal regulation
-acidosis -alkalosis |
-acidosis: pH= 7.35 or lower. in acidosis (increase in H+), kidneys release H+ and conserves HCO3 and K+ (will make it more basic). *HCO3 binds to H+ to decrease it
-alkalosis: In alkalosis (decrease in H+), kidneys conserve H+ and secrete HCO3 and K+. *loss of HCO3 frees H+ and H+ increases |
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What do the kidneys do?
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Gets rid of H or HCO3
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Lung regulation
-how long does it take? |
Works rapidly--within minutes!
-lower CO2=pH increase (basic) -higher COs=pH decreases (acidic)--> increase respirations to get rid of CO2--->pH increase |
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Lung regulation
-acidosis -alkalosis |
-lung acidosis: slower breathing retains CO2 and produces acidosis (lower pH) ... hypoventilation-->increase respirations and blow off CO2
-lung alkalosis: hyperventilation-->faster breathing eliminates CO2 and produces alkalosis (lower CO2=pH increase (basic))-->decrease respirations to retain CO2 |
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Trying to correct
-acidosis (lower pH) |
-metabolic: excrete H+ (acid
-kidney: keep HCO3 (base) -respirations/lungs: get rid of CO2 (acid) and increase respiratory rate |
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Trying to correct
-alkalosis (increase pH) |
-metabolic: conserve H+ (acid)
-kidney: excrete HCO3 (base) -respirations/lungs: keep CO2 (acid) and decrease respiratory rate |
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Respiratory acidosis
-definition -CO2 value -pH level -causes |
-definition: failure to remove CO2 (keep CO2 in)
-CO2 > 45 mmHg -pH < 7.35 -causes: hypoventilation (RR<12). Acute acidosis: CNS depression (narcotic overdose), respiratory depression, sleep apnea. Decreased surface area of lung and airway obstruction. Chronic acidosis: COPD |
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What are the clinical manifestations for respiratory acidosis?
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-mild acidosis: dyspnea, tachycardia (due to hypoventilation), drowsy, increased CO2 levels, decreased O2 levels
-severe acidosis: severe hypoxemia, flushed skin, increased serum K+ (H in cell, K our of cell) -chronic acidosis: chronic low grade headache, increased HCO3 (compensation) *COPD |
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Respiratory acidosis summary
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-pH= 7.35 or lower
-CO2= > 45 -main cause=hypoventilation |
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Respiratory alkalosis summary
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-pH=7.45 or above
-CO2= <35 -main cause: hyperventilation ( |
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Patho of respiratory acidosis
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-CO2 retained, decreased elimination of CO2
-increased H+ in serum= high CO2 and low pH -increase RR + depth, lower CO2 retentaion -compensatory mech: retain HCO3, H+ excreted in kidneys, H+ moves in cell, K+ moves out of cell |
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Respiratory alkalosis
-definition -CO2 level -pH -causes |
-definition: failure to retain CO2
-CO2 < 35 mmHg -pH > 7.45 -causes: hyperventilation (RR > 20) due to exercise, pain, anxiety. TMI, high altitudes, excessiv mechanical ventilation (set RR too high on a ventilator) |
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What are the clinical manifestations of respiratory alkalosis?
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-rapid shallow respirations (panting)
-lightheaded, dizzy, vertigo -peripheral/circumoral numbness, tingling -muscle spams -cardiac rhythm disturbances due to low serum K+ -K is in cells, not the blood **lower RR, keep H, get rid of HCO3 |
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Patho of respiratory alkalosis
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-CO2 "blown" off, increased elimination of CO2
-lower H in serum=higher pH, lower CO2 -compensatory mech: lower RR and depth -high H reabsorption and HCO3 excretion through kidneys. H moves extra (into blood), K moves intra (into cell) |
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Metabolic acidosis
-definition -HCO3 level -pH level -causes |
-definition: loss of base or increase in acid
-HCO3 < 22 mEq/L -pH < 7.35 -causes: loss of base (diarrhea), gain in acids (starvation, renal failure), ASA overdose (lactic acidosis) |
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Clinical manifestations of metabolic acidosis.
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-headache
-disorientation to stupor -seizures -cardiac arrhythmias due to increased K, K responsible for electrical conduction -Kussmaul's respirations: acute situation (diabetic-->fruity breath)--->RR greater than 20, increased depth (like when you run) |
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Patho of metabolic acidosis
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-gain in H and loss of HCO3, capacity of kidney
-lower pH and lower HCO3 -compensatory mech: H moves intracellular, K moves extracellular -increase in RR and depth, CO2 excretion (respiratory center is stimulated), H excreted through kidneys, HCO3 retained |
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Metabolic alkalosis
-definition -HCO3 level -pH -causes |
-definition: increase in base of loss of acid
-HCO3 > 26 mEq/L -pH > 7.45 -causes: loss of acid (H) due to gastric suctioning, vomiting (stomach contents are acidic), diuretic therapy (K deficit). Gain in base (ingestion of excess of sodium bicarb (increase antacid use) |
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Clinical manifestations of metabolic alkalosis
|
-gain in HCOs and loss of H
-increase in pH and increase in HCO3 -compensatory mech: H moves extra (into blood), K moves intra (into cell) -lower RR + depth, CO2 retention -HCO excreted through kidneys, H retained |
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Patho of metabolic alkalosis
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-gain in HCO3 and loss of H
-increase pH and increase HCO3 -compensatory mech: H moves extra, K moves intra -lower RR + depth, CO2 retention -HCO excreted through kidneys, H retained |