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N271-01: Class #1
Acid-base balance and Arterial blood gases
| Question | Answer |
|---|---|
| ______ is when the body constantly maintains an internal optimal environment/balance between acids and bases; without this, cells won't function properly. | homeostasis |
| cells use nutrients to produce energy to function. 2 biproducts are produced, namely _____ and _____. | CO2 (carbon dioxide); H+ (hydrogen ions) |
| ________ determines acidity or alkalinity. It is measured by the ______. | H+ concentration; pH |
| H+ and pH are _____ proportional. Meaning when H+ is high, pH is ______ and when H+ is low, pH is _______. | low; high |
| When H+ is high and pH is low, the ABG is considered to be ______. | acidic |
| When H+ is low and pH is high, the ABG is considered to be _______. | alkalotic |
| ______ represents the balance between H+ (hydrogen ions) and HCO3 (bicarbonate ions). | acid-base |
| _______ is the major extracellular anion electrolyte. | bicarbonate (HCO3) |
| _______ is the major extracellular cation electrolyte. | sodium (Na) |
| _______ is the major intracellular anion electrolyte. | potassium (K) |
| What is the normal pH range? | 7.35-7.45 |
| What is the happy place of our pH? | 4.0 |
| What is the pH during an acidosis? | less than (<) 7.35 |
| What is the pH during an alkalosis? | more than (>) 7.45 |
| What factors directly affect the acid-base balance and which systems are they responsible for? | pH (blood), paCO2 (respiratory system), HCO3 (metabolic /renal system) |
| ______ is the partial pressure of CO2 in the arterial blood which tells us how well the pt is breathing. The normal range is _______. | paCO2; 35-45mm/Hg |
| PaCO2 (carbonic acid) has an ______ relationship with the pH. | inverse |
| ____ paCO2 and ____ pH indicates respiratory acidosis. | high; low |
| _____ paCO2 and _____ pH indicates respiratory alkalosis. | low; high |
| When the pt is hypoventilating/having trouble breathing causing them to retain acid (paCO2), the pt will experience ______. | respiratory acidosis |
| When the pt is hyperventilating/breathing too fast causing them to release acid (paCO2), the pt will experience ________. | respiratory alkalosis |
| HCO3 (bicarbonate) is the major extracellular electrolyte and has a _____ relationship with the pH. The normal range is _______. | direct; 22-26mEg/L |
| _____ HCO3 and _____ pH indicates metabolic acidosis. | low; low |
| _____ HCO3 and _____ pH indicates metabolic alkalosis. | high; high |
| When the pt has diarrhea causing them to lose HCO3, the pt will experience _________. | metabolic acidosis |
| When the pt is vomiting causing them to lose HCl, the pt will experience _________. | metabolic alkalosis |
| ______ is the partial pressure of O2. When it's too low, pt will experience hypoxia b/c the alveoli are destroyed. | paO2 |
| _____ is the measurement of O2 saturation and sometimes the # can be false due to altering factors such as nail polish, etc. | saO2 |
| What are the three primary systems that regulate H+ concentration in the body fluids? | buffer, respiratory, renal |
| ______ is the 1st line of defense against ABC imbalance and is the most efficient balancing weapon. It kicks in to minimize imbalance by combining with excess acids and bases to neutralize until something else takes over. | chemical buffers |
| What are the three main buffers? | bicarbonate, phosphate, protein |
| ______ buffers blood and interstitial fluid by decreasing the strength of the damaging acid-base imbalance; works with respiratory and renal systems. | bicarbonate |
| _______ is an effective buffer in the renal tubules b/c a greater concentration is found there. | phosphate |
| _______ is the most plentiful buffer and binds with acid-base to neutralize. Albumin is the major type for this buffer in the cardiovascular system. | protein |
| _________ is the 2nd line of defense against ABC imbalance. It regulates the blood levels of CO2 (gas that combines with carbonic acid). This system becomes twice as effective b/c it can handle 2x the number of ABC. | respiratory system (lungs) |
| ________ are found in the medulla. They sense the change in pH and vary the rate and depth of breathing to compensate for the imbalance. | chemoreceptors |
| If the pt is retaining CO2, the chemoreceptors will cause the pt to breathe _____ and ______ CO2. | faster; expel |
| If the pt is blowing off CO2, the chemoreceptors will cause the pt to breathe _____ and ______ CO2. | slower; retain |
| _______ system will respond quickly (minutes) but the compensation is temporary. | respiratory |
| ________ is the 3rd and final defense to regulate ABC imbalance. It can adjust blood pH by excretion of H+ and conservation of HCO3. | renal system (kidneys) |
| The renal system _____ acid and bases and _____ them in the urine. It regulates the _____ level which reflects the metabolic aspect of ABC. | reabsorbs; excretes; bicarbonate |
| ______ system will take a while to kick in (hrs/days) but the correction effects are long term. | renal |
| T or F: respiratory helps metabolic and metabolic helps respiratory. | T |
| When the body retains acid (H+) and there is lack of bicarbonate (HCO3), the pt will experience ___________. | metabolic acidosis |
| T or F: the respiratory system compensates for metabolic acidosis through respiratory alkalosis (increasing rate of breathing to blow off CO2). | T |
| An example of metabolic acidosis is ______. | diarrhea |
| When the body releases acid (H+) and retains excess bicarbonate (HCO3), the pt will experience _________. | metabolic alkalosis |
| T or F: the respiratory system compensates for metabolic alkalosis through respiratory acidosis (decreasing rate of breathing to retain CO2). | T |
| An example of metabolic alkalosis is _______. | vomiting |
| When the pt is hypoventilating (8 RR), their paCO2 will be elevated indicating CO2 retention. The pt will then experience _______. | respiratory acidosis |
| T or F: the renal system compensates for respiratory acidosis through metabolic alkalosis (high HCO3 and low H+). | T |
| T or F: when the pt is experiencing respiratory acidosis, you SHOULD administer narcotics, benzos, and morphine to avoid respiratory dry. | F |
| When the pt is hyperventilating, their paCO2 will be low indicating CO2 release. The pt will then experience _________. | respiratory alkalosis |
| T or F: the renal system compensates for respiratory alkalosis through metabolic acidosis (low HCO3 and high H+). | T |
| During _________, pt experiences alveolar hypoventilation, decreased respirations, and inadequate gas exchange. Pt will have increased paCO2 (>45 mEq/L), low pH, and the kidney will try to conserve HCO3 to increase pH. | respiratory acidosis |
| Morbid obesity, opiate overdose, chest trauma, foreign body aspiration, COPD due to mucus and inflammation are causes of _________. All causing the pt to breathe slower. | respiratory acidosis |
| Headache (CO2 causes vasodilation causing increased blood to the brain), altered LOC (CNS depression leads to disorientation but get the baseline bc it might/might not be secondary), restlessness, & tachypnea leading to cardiac arrest are s/s of ______. | respiratory acidosis |
| To treat respiratory acidosis, ventilation should be _____ to _____ paCO2. | improved; lower |
| A bronchodilator such as ________ can be administered to open up constricted vessels during resp. acidosis. | albuterol OR Proventil |
| A mucolytic such as ________ can be administered to thin and clear airway by excreting mucus during resp. acidosis. | acetylcysteine OR Mucomyst |
| A ______ can also be administered for oxygen therapy during resp. acidosis. | nasal cannula |
| A _______ can be administered if pt is desaturated during resp. acidosis. | ventilatory support |
| During ________, pt experiences alveolar hyperventilation and increased respirations. Pt have hypocapnia/decreased paCO2 (<35 mEq/L) and increased pH. | respiratory alkalosis |
| Hyperventilation, psychological stress, stimulation of sympathetic nervous system -> palpitations, fever, and sepsis are causes of _______. | respiratory alkalosis |
| Tachycardia, anxiety, restlessness, ECG changes, complaints of light headedness, confusion, and apnea are signs and symptoms of _______. | respiratory alkalosis |
| T or F: when excessive amount of CO2 is exhaled, it DOES NOT stimulate the carotid and aortic bodies in the medulla that leads to tachycardia. Hence, there WON'T be a PR interval of <0.4 and a monitor WON'T be attached. | F |
| T or F: less CO2 causes vasoconstriction impeding blood flow to the brain causing the complaints of light headedness. | T |
| T or F: due to extreme alkalosis, the H+ concentration decreases and increases cerebral interstitial fluid which DOES NOT alters brain cell function causing confusion. | F |
| To treat respiratory alkalosis, we can administer ______ to eliminate the fever. | antipyretics |
| ______ such as ______ can be administered to eliminate the source of sepsis due to resp. alkalosis. | antibiotics; penicillin |
| ______ can be administered to treat acute hypoxemia caused by resp. alkalosis. | O2 |
| _______ can be administered to help with the anxiety caused by resp. alkalosis. | sedative |
| ______ occurs when there's too much H+ and too little HCO3 in the body. This can cause ventricular arrythmia leading to cardiac arrest. | metabolic acidosis |
| Diabetic Ketoacidosis (DKA), chronic alcoholism, kidney failure, and diarrhea are causes of ________. | metabolic acidosis |
| _______ is a condition of overproduction of ketones b/c glucose are all used up so it uses fat for energy. It also causes us to urinate a lot b/c the renal threshold has been reached making the tubules unable to absorb glucose. | DKA |
| T or F: chronic alcoholism causes an UNDERPRODUCTION of H+. | F |
| During ______, there is no urine output so H+ builds up and causes metabolic acidosis. | kidney failure |
| During ______, there is excess excess excretion of HCO3 causing metabolic acidosis. | diarrhea |
| The s/s of _______ are kussmaul respirations+ fruity breath (if DKA), CNS depression, lethargy, dull headache (low cardiac output, low BP = vasodilate = blood rushing through the brain), and confusion. | metabolic acidosis |
| To treat metabolic acidosis with DKA, we should administer ______ and ______ fluid. | insulin; replace |
| During metabolic acidosis, we should monitor potassium levels (3.5-5 mEq/L) b/c of _______. | osmotic diuresis wherein K+ gets kicked out of the cell due to the influx of H+ into the cell. |
| We should administer _______ during metabolic acidosis to balance it out. | HCO3 |
| _______ is the last resort if the pt has no output. | hemodialysis |
| During ABC imbalances, pt might experience __________, so it's best not to treat them if dehydrated until the values are back to normal. | relative hypokalemia |
| ________ occurs when there is a decrease in H+ concentration and an increase in HCO3. | metabolic alkalosis |
| Diuretic therapy, hypokalemia (main concern), vomiting, and NG suctioning are causes of ________. | metabolic alkalosis |
| Slow shallow respirations, hypokalemia, hypocalcemia, EKG changes (v-fib and ventricular tachycardia), and neuromuscular excitability are s/s of _______. | metabolic alkalosis |
| We should ______ the loop or thiazide diuretics to treat metabolic alkalosis. | discontinue |
| ______ the NG suctioning to treat metabolic alkalosis. | stop |
| Administer ______ to keep the pt from vomiting and treat metabolic alkalosis. | antiemetic |
| Have you practiced ABGs through the site? | yes |
Created by:
yortiz
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