Egan's Ch. 13 Word Scramble
L B O A S L P M O A D
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| Question | Answer |
| what is the common blood fluid compartment that both open and closed buffer systems function? | blood plasma |
| what maintains CO2 levels? | lungs |
| what kind of acids are phosphoric acid and sulfuric acid? | fixed |
| what does the buffering of a fixed acid produce? | CO2 |
| what does the non-bicarbonate (closed) buffer system consist of? | phosphates and proteins, including Hb |
| how much fixed acid is excreted per day by the kidneys? | <100 mEg |
| how do the kidneys compensate for respiratory alkalosis? | by excreting HCO3 in the urine |
| what are ways to correct metabolic acidosis? | if above 7.2, nothing, dr. will need to treat underlying condition if below 7.2, intravenous infusion of NaHCO3 |
| what does pH = 6.1 + log HCO3-/(PaCO2 x 0.03) represent? | H-H equation |
| what is the most important non-bicarbonate buffer system? why? | Hb it is the most abundant |
| what is the anion gap? | the calculation of 4 electrolytes (Na+, Cl-, K+, and HCO3-) |
| what is the third step in analyzing acid-base problems? | determine metabolic involvement plasma HCO3- |
| what are some of the symptoms of metabolic acidosis? | dyspnea,hyperpnea, Kussmaul's breathing, lethargy, coma |
| what is a buffer solution? | a mixture of acids and bases that resist changes in pH when an acid or a base gets added to it |
| H+ regulation is of utmost biological importance? T or F | true |
| how is BE expressed? | mEq/L |
| what can be done to correct respiratory acidosis and improve alveolar ventilation? | bronchial hygiene,lung expansion, non-invasive PPV, intubation, mechanical ventilation |
| a decrease in ___ or an increase in ___ leads to acidemia. (ratio less than 20:1) | HCO3- PCO2 |
| what is the importance of the H-H equation? | it equals the pH of blood plasma, and since all buffer systems in the blood are in equilibrium, the pH of one system equals the pH of the entire plasma solution. |
| HHb= Hb- + H+ | Hb buffering/transporting H+ |
| what is alkalemia? | decreased hydrogen ion concentration in the blood; blood pH greater than 7.45 |
| What maintains bicarbonate levels? | kidneys |
| what acids acids does an open buffer system buffer? | fixed, only when ventilation is not impaired, plus any individual H+ regardless of origin |
| what continuously generates H+? | normal metabolism |
| what property of H+ is the reason for the need to regulate its concentration? | it reacts readily with the protein molecules of vital cellular catalytic enzeymes |
| what is the second step in analyzing acid-base problems? | determining respiratory involvement PaCO2 |
| how do the kidneys compensate for respiratory acidosis? | by reabsorbing HCO3 back into the blood |
| what is the difference called between the normal buffer base and the actual buffer base in a whole blood sample? | base excess (BE) |
| wat is the normal, life sustaining, pH range of the body? | 7.35-7.45 |
| what is the goal of secreting less H+? | to increase the amount of HCO3- in the urine, increase the amount of H+ in the blood |
| what is the state called in which arterial blood is more acidic than normal? aka increased concentration of hydrogen ions. | acidemia |
| at what pH are severe cardiac arrhythmias likely? | below 7.2 |
| what is a physiological example of a volatile acid? | carbonic acid |
| why is the H-H equation useful in a clinical setting? | you can use it to see if the pH, PCO2, and HCO3 values for an abg are compatible; prevents transcription errors amd analyzer inaccuracies; also, to predict the result of changing the value of one or more of the variable |
| H+ + HCO3-= H2CO3 | carbonic acid, bicarbonate + hydrogen ion |
| what are some ways to correct metabolic alkalosis? | increased intake of fluids containing Cl-; in hypokalemia- administering KCl (potassium chloride) if severe- HCl or ammonium chloride |
| define metabolic acidosis? | non-respiratory processes resulting in acidemia |
| why can H+ be dangerous? | its reactions with proteins can change their physical contour, rendering the enzyme inactive |
| what is the ratio of HCO3- buffer/dissolved CO2 that maintains a normal pH? | 20:1 |
| what can be done to correct respiratory alkalosis? | O2 therapy |
| in a closed buffer system, when does buffering activity stop? | when Hbuf reaches equilibrium with the reactants |
| in what 2 ways can metabolic alkalosis occur? | loss of fixed acids or gain of blood buffer base; either one increases plasma HCO3 |
| what is indicated by an anion gap >16? | metabolic acidosis |
| what is the presence of lower than normal amounts of CO2 in the blood (PaCO2)? | hypocapnia |
| what is the normal BE? | +2 mEq/L |
| what gas is carbonic acid (H2CO3) in equilibrium with? | dissolved CO2 |
| define respiratory alkalosis? | hyperventilation, resulting in alkalemia |
| what does the bicarbonate (open) buffer system consist of? | H2CO3 and a conjugate base of HCO3- |
| what is the first step to analyzing acid-base problems? | categorizing pH pH scale |
| what factor determines how much H+ is removed by the kidneys? | blood pH |
| what is the normal range of arterial bicarbonate? | 22-26 mEq/L |
| what are the primary acid excreting organs? | lungs and kidneys |
| examples of open buffer systems | plasma erythrocytes |
| what happens when filtrate pH reaches 4.5? | secretion ceases to function and H+ secretion stops |
| what is the normal anion gap range? | 8-16 |
| what is hypercapnia? | excess amounts of CO2 in the blood (PaCO2) |
| why is CO2 elimination crucial? | it reacts with H2O to form large quantities of H2CO3 |
| what does a fixed acid represent? | the by-product of protein catabolism |
| how do the lungs compensate for metabolic alkalosis? | by hypoventilating |
| open and closed buffer systems function in isolation. T or F | false, they are intermingled in the same solution (whole blood) and are equal in pH (isohydric principle) |
| how much does plasma HCO3 increase with acute increase in PCO2? | about 1 mEq/L for every 10 mm Hg increment over 40 |
| what is the main function difference in between an open and closed buffer system? | open- removes components of acid-base reactions through ventilation closed- all components of acid-base reactions remain in the system |
| in which 2 ways can metabolic acidosis occur? | acid accumulation in the blood or excessive loss of HCO3 |
| what is called when non-respiratory processes, such as losing fixed acid or gaining HCO3-, result in alkalemia? | metabolic alkalosis |
| on a pH-CO2 diagram showing the hydration reaction between CO2 and H2O, if theres is an increase of CO2 from 40 to 80 what happens to the value of the HCO3? | it increases from 24 to approximately 28.5 |
| how are blood buffers classified? | as either bicarbonate (open) or non-bicarbonate (closed) buffer systems |
| various physiological mechanisms regulate ____ in a range compatible with life ( aka acid-base balance). | the H+ concentration of body fluids |
| if one acid-excretion system fails, the other will compensate. T or F | true; especially in diseased individuals |
| what is the buffer base? | the total blood buffer capable of binding hydrogen ions |
| what are some of the causes on high anion gap metabolic acidosis? | lactic acidosis, ketoacidosis, renal failure. aspirin, formic acid, ethylene glycol |
| what are some of the causes of metabolic alkalosis? | vomiting, hypokalemia |
| how does the respiratory system compensate for increased fixed and volatile acid production? | ventilation |
| the kidneys also regulate HCO3 levels. T or F | true; when large amounts of H+ are excreted, the HCO3 is reabsorbed back into the blood and vice vera |
| what are some of the causes of respiratory acidosis? | anesthesia, narcotics, and sedatives poliomyelitis, myasthenia gravis, guillian-barre syndrome trauma to spinal cord, brain, chest wall, kyphoscoliosis, obesity COPD, airway obstruction |
| how do the lungs compensate for metabolic acidosis? | hyperventilation |
| what are some of the causes of respiratory alkalosis? | anxiety, fear, stimulant drugs, CNS lesion, pain, sepsis hypoxemia, asthma, pneumonia, pulmonary edema, pulmonary vascular disease latrogenic hyper ventilation |
| what is the normal blood buffer base (NBB) range? | 48-52 mEq/L |
| What is the PCO2 baseline for standard bicarbonate? | 40 mm Hg |
| what are some signs of respiratory alkalosis? | paresthesia, dizziness, headache, hyperventilation |
| what are the 2 major mechanisms responsible for maintaining a stable pH despite CO2 production? | isohydric buffering and ventilation |
| the plasma concentration of HCO3- that exists if PCO2 is normal is known as ____ | standard bicarbonate |
| what is the most complicated acid-base imbalance to treat? | metabolic alkalosis; it involves fluid and electrolyte imbalances |
| when ___ increases or ___ decreases, it leads to alkalemia.(ratio greater than 20:1) | HCO3- PCO2 |
| how much CO2 does normal ventilation eliminate everyday? | 24,000 mmol/L total 13,000 mmol/L of volatile |
| interpret the ABG: pH- 7.2 PaCO2- 30 HCO3- 15 | partial compensated metabolic acidosis |
| pH changes caused by PaCO2 are referred to as what? | primary respiratory disturbances |
| how does the hydration reaction produce HCO3? | CO2 and H20 create H2CO3, Hb snatches the H+, thus resulting in HCO3 CO2+H2O-->H2CO3-->HCO3- | Hb+H-->HHb |
| which has the greater buffering capacity, a closed or open system? | open |
| what is the goal of secreting more H+? | to increase the amount of HCO3- in the blood, decrease the amount of H+ in the blood |
| interpret the ABG: pH- 7.52 PaCO2- 40 HCO3- 30 | uncompensated metabolic alkalosis |
| examples of closed buffer systems | Hb, organic and inorganic phosphates, and plasma proteins |
| which is faster at removing acid, lungs or kidneys? | lungs |
| what would be the results of an ABG if patient is hypoventilating? (uncompensated) | pH - less than 7.35 PaCO2 - greater than 45 HCO3 - 22-26 respiratory acidosis |
| what is the last step in analyzing acid-base problems? | assess for compensation |
| how do u calculate base excess? | add all positive ions (cations) then add all negative ions (anions) then find the difference between the two (in mEq/L) |
| effect of small changes in the hydrogen ion concentration? | failure of vital metabolic processes |
| what disease can increases fixed acid production? | diabetes |
| what would be the results of an ABG if the patient is hyperventilating? (uncompensated) | pH - greater than 7.45 PaCO2 - less than 35 HCO3 - 22-26 respiratory alkalosis |
| what is the purpose of using the anion gap? | to eliminate the effects of respiratory involvement; aka to see whats going on at the metabolic level |
| what is a titrable, nonvolitile acid called? | fixed acid |
| define respiratory acidosis. | hypoventilation, the loss of HCO3- or gaining fixed acids resulting in acidemia |
| what acids acids does a closed buffer system buffer? | volatile and fixed |
| what are some of the causes of normal anion gap metabolic acidosis? | diarrhea, pancreatic fistula. renal tubular acidosis. ammonium chloride, hyperalimentation intravenous nutrition |
| what is an acid that can be excreted in its gaseous form? | volatile acid |
| how is standard bicarbonate expressed? | mEq/L |
| what is the Henderson-Hasselbalch (H-H) equation? | the specific equation for calculating the pH of the bicarbonate buffer system of the blood |
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