Resp: Acid-Base Disorders - (Barnes) - JCN
What are the causes of respiratory ALKALOSIS
Anxiety
What are some causes of CHRONIC respiratory acidosis?
Asthma COPD Pulmonary edema Severe OBESITY Neuromuscular disease Scoliosis
What are some causes of respiratory acidosis?
CNS depression drugs Neuromuscular disorders (myopathy/neuropathy) Acute airway obstruction (laryngospasm, bronchospasm) Severe pneumonia/pulm. edema Impaired lung motion Thoracic cage injury Ventilator dysfunction
Case 4 steps: Alk/Acid? pH? AG? Compensation?
Chronic resp acidosis
Case 2 steps Alk/Acid? pH? AG? Compensation?
Expected Bicarb is 30 Why is there a difference? - because the pt has chronic disease...a chronic disease can present acutely...
What is the basic formula for ACID/BASE in the form of an ACIDOSIS (primary metabolic)? ___pH ___HCO3- ___PCO2
Primary metabolic acidosis = pH lower because of a decrease in HCO3- With that change the lungs compensate
What are the steps for an acid base case?
STILL calculate the Anion gap
Some CHRONIC causes of REsp. alkalosis are?
Stress Thermal insult HIGH ALTITUDE Fever Drugs (salicylates) Pregnancy Sepsis Hepatic encephalopathy Mechanical ventilation
Do you calculate the delta gap? Whats the answer?
YES Respiratory ALKALOSIS with a METABOLIC ANION GAP ACIDOSIS
In a PRIMARY RESPIRATORY acidosis, what is the basic formula? ___pH ___HCO3- ___PCO2
pH goes DOWN as a result of the INCREASE in PCO2 After 24-48 hours the kidneys respond causing an INCREASE in HCO3-
