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19 Cards in this Set
- Front
- Back
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what is associated with metabolic alkalosis?
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almost always associated with renal impairment of some kind (chronic)
results from accumulation of bicarb in the plasma think RENAL IMPAIRMENT |
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causes of metalbolic alkalosis?
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vomiting
nasogastric suction posthypercapneic alkalosis rapid infusion of biarb, lactate, or citrate renal causes some diuretics (i. e. furosemide) hyperaldosteronism |
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compensation for metabolic alkalosis
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Respiratory: hypoventilation
Kidneys attempt to excrete excess bicarb |
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pH 7.5
pCO2 44mmHG pO2 95mmHg O2 saturation 97% HCO3 32mEq/L Does this patient have an acid / base disorder? Is compensation taking place? |
1. alkalosis due to high HCO3, metabolic alkalosis
2. compensated because PCO2 is up |
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pH = 7.27
PCO2 = 70 mmHg HCO3- = 29 mEq/L Cl- = 95 mEq/L Na+ = 138 mEq/L Does this patient have an acid / base disorder? Is compensation taking place? |
1. acidosis due to PCO2, respiratory acidosis
2. increased bicarb, so you have a compensation occurring |
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What 2 ways does K+ play a role in acid/base balance?
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K+ is often moved into / out of cells to compensate for Δ [H+] : (intracellular buffering)
alkalosis: H+ moves out of cell – K+ into cells…hypokalemia acidosis: H+ moves into cell – K+ out of cells…hyperkalelmia |
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how are Ca and H+ related?
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Ca++ binds to anionic proteins…as [H+] Δ more / less Ca++ will be bound to plasma proteins: (plasma protein buffering)
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in alkalosis, will you have hypo or hypercalcemia?
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alkalosis: proteins more (-), more Ca++ binds…hypocalcemia
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in acidosis will you have hypo or hypercalcemia?
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acidosis: proteins less (-), less Ca++ binds…hypercalcemia
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Na+ is accompanied by secretion of what?
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H+
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if Cl- is depleted, what does this promote?
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the loss of H+ and K+ to maintain electroneutrality
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What type of acid/base problem does reduced Cl- facilitate?
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metabolic alkalosis
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PO2: 98
pH: 7.08 PCO2: 16 HCO3: 5 meq acidosis or alkalosis? |
metabolic acidsosis
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Na: 138
K: 4.9 Cl: 100 anion gap=? |
anion gap= 133
MUDPILES could be a ketoacidosis, renal failure, lactic acidosis, etc. |
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pH 7.55
PCo2: 52 HCO3: 44 acid base disturbance? is the pt compensating? |
metabolic alkalosis
absolutely |
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A woman with chronic emphysema of long standing who came down with severe bronchitis for a week..Near the end of this week she would be expected to show a higher?
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chronic respiratory acidotic state
bicarb will go up in response |
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a comatose boy who had ingested a large quantity of methanol was found to have a CO2 of 5mmo/L and an anion gap of 31. What did he have?
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metabolic acidosis
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PO2= 55
pH= 7.14 PCO2=85 what you got? |
respiratory acidosis
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PO2= 103
pH=7.6 PCO2= 20 mmHg what do you have? |
respiratory alkalosis
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