Acid Base Balance(Nursing)

Front 1

Normal PH level

Back 1

7.35 and 7.45

Front 2

In ACIDOSIS, the___goes__ and the ___rate and ____ go___ in attempt to blow off acids. The carbonic acid created by the neutralizing action of HCO3 can be carried to the ____ where it is reduced to ____ and ___ and exhaled. Thus H+ ions are inactivated.

Back 2

PH, down
respiratory rate, depth, up
lungs
carbon dioxide, water

Front 3

In ALKALOSIS, the___goes ___and the ___and ___go down. Co2 is retained, and the carbonic acid concentration increases to neutralize and decrease the strength of excess HCO3.

Back 3

PH, up
respiratory, depth, down

Front 4

Carbonic Acid- HCO3 system ratio

Back 4

20:1
Maintains a PH of 7.4 with a ratio of 20 parts HCO3 to 1 part carbonic acid

Front 5

The carbonic acid concentration is controlled by excretion of __ by the __. The___and__of___change in response to CO2 levels.

Back 5

Co2(carbon dioxide)
lungs
rate, depth, respirations

Front 6

The HCO3 concentration is controlled by the___. Which selectively ___ or___HCO3 in response to the body needs.

Back 6

kidneys
retain, secrete

Front 7

Potassium acidosis

Back 7

The body protects itself from the acid state by moving H+ ions into the cell, K moves out to make room for H+ ions. K level increases

Front 8

Potassium alkalosis

Back 8

The cells release H+ ions into the blood in attempt to increase the acidity of the blood. K moves into the cells, K level decreases.

Front 9

Respiratory Acidosis

Back 9

The total concentration of buffer base is lower than normal.
Increase in H+ concentration more H+ ions are circulating in the blood.

Front 10

Any condition that causes an obstruction of the airway or depresses respiratory status can cause____.

Back 10

Respiratory acidosis

Front 11

respiratory acidosis causes
(H BBBAAC PERM)

Back 11

Hypoventilation

Brain trauma
Bronchitis
Bronchiectasis
Asthma
Atelectasis
Central nervous system depression

Pneumonia
Pulmonary edema
Emphysema
Respiratory failure or depression
Medications

Front 12

respiratory acidosis s/s
(CDDRR VHHM)

Back 12

Cyanosis as hypoxia becomes more acute
Diaphoresis
Dysrhythmias leading to ven. fib.
Rapid, irregular pulse
Restlessness

Visual disturbances
Headache
Hyperkalemia
Mental status changes(drowsiness,and confusion)

Front 13

respiratory acidosis interventions
(AATE PPMMS)

Back 13

Adm. O2 (AP)
Avoid tranquilizers, opioids,sedative, hypnotics (further depress resp.)
Turn client to cough and deep breathe
Encourage hydration to this secretions unless excess fluid is contra

Place pt. in Semi Fowlers unless contraindicated
Prepare to adm. chest physiotherapy and postural drainage(AP)
Maintain patent airway
Monitor signs of resp. distress
Suction client prn

Front 14

Conditions that causes overstimulation of the respiratory system.

Back 14

respiratory alkalosis

Front 15

respiratory alkalosis causes
(OPFAHHH)

Back 15

Overventilation by mechanical ventilators
Pain
Fever
Anxiety
Hypoxia
Hyperventilation
Hysteria

Front 16

respiratory alkalosis s/s
(PM LIHHT)

Back 16

Paresthesias, such as tingling of the fingers and toes
Mental status changes

Lightheadedness, vertigo
Initially hyperventilation & resp. stimulation cause abnormal rapid and deep resp. in attempt to compensate, the resp rate and depth than decrease
Headache
Hypokalemia, hypocalcemia
The PH is <than>< than 35mm Hg

Front 17

respiratory alkalosis interventions
(PPMM)

Back 17

Provide cautious care with ventilator clients so that they are not forced to take deep breaths too deeply or rapidly
Prepare to assist with adm. calcium gluconate for tetany (AP)
Maintain patent airway
Monitor electrolyte values esp K+ and calcium.

Front 18

The total concentration of buffer base is lower than normal. with relative increase in the H+ ion concentration, this occurs as a result of losing too much acid without sufficient base.

Back 18

metabolic acidosis

Front 19

metabolic acidosis causes
(IM GED LR HSS)

Back 19

Insufficient metabolism or carbs
Malnutrition

Gastrointestinal fistulas
Excessive ingestion of aspirin
Diabetes mellitus or diabetic ketoacidosis

Lactic acidosis
Renal insufficiency or renal failure

High fat diet
Severe diarrhea
Starvation

Front 20

metabolic acidosis s/s
(FINCHH)

Back 20

Fruity smelling breath as a result of improper fat metabolism
In an attempt to blow off the extra CO2 and compensate for the acidosis, hyperpnea with Kussmaul resp(deep and fast) occurs.
Nausea and vomiting
CNS depression, mental dullness, drowsiness, stupor, coma
Hypotension
Hyperkalemia

Front 21

metabolic acidosis interventions

Back 21

Seizure precautions
Assess LOC for CNS depression
Monitor patent airway
Monitor I&O
Monitor serum K+ levels

Front 22

A deficit loss of H+ or acids or an excess of base HCO3, results from the loss of acid without a comparable loss of bass in the body fluids.

Back 22

metabolic alkalosis

Front 23

metabolic alkalosis causes
(HINTDD)

Back 23

Hypokalemia, hypocalcemia
In an attempt to compensate, RR and depth decrease to conserve CO2
Numbness and tingling in the extremities
Twitching in the extremities
Dizziness
Dysrythmia, tachycardia

Front 24

metabolic acidosis interventions
(IMMPP)

Back 24

Institute seizure precautions
Maintain patent airway
Monitor K and calcium levels
Prepare to replace K chloride(AP)
Prepare to adm. meds(AP) to promote the excretion of HCO3

Front 25

ABG
(aterial blood gas) definition

Back 25

Levels reflect the effectiveness of the lungs to exchange O2 & CO2

Kidneys to balancing the retention and elimination of HCO3

The effectiveness of the heart as a pump

Front 26

ABG specimen- How to obtain
(Vicky asked is Peter eyes always really low)

Back 26

Vicky- VS
Asked- Allen's test
Is- Identify factors that may affect accuracy
Peter- Prepare a heparinized syringe
Eyes- Emotional support to client
Always- Apply pressure stat to the puncture site for 5-10 min if pt is taking anticouagulants
Really- Record pt temp, type of supplemental O2
Low- Label the specimen, transport it to lab

Front 27

What is Allen's test?

Back 27

Apply pressure on pt. ulnar and radial arm same time,
While pressure is applied ask pt to open and close hand repeatedly. Hand should blanch
Release pressure from the ulnar artery, assess color of the extrem. distal to the press. point.
If pinkness fails to return within 6 secs, the ulnar artery is insufficient. The radial artery should not be used for obtaining a bld. specimen.

Front 28

respiratory imbalance
PH is ____ of the PCO2.

Back 28

opposite.

PH up PCO2 down
PH down PCO2 up

Front 29

metabolic imbalance
PH is ___ as the HCO3.

Back 29

same

PH up HCO3 up
PH down HCO3 down

Front 30

acid base imbalances
fun fact

Back 30

respiratory (opposite of pH)
metabolic (same)

Front 31

PH level

Back 31

7.35 to 7.45

Front 32

PCO2 level

Back 32

35 to 45 mm Hg

Front 33

HCO3 level

Back 33

22 to 27 mEg/L

Front 34

PaO2 level

Back 34

80 to 100 mm Hg