HURST Review: Acid-Base Balance

Metabolic Acidosis: Which organ has a problem?

kidneys

Metabolic Alkalosis: Which organ has a problem?

kidneys

Respiratory Acidosis: Which organ is going to compensate?

kidneys

Respiratory Alkalosis: Which organ is going to compensate?

kidneys

Metabolic Acidosis: Too much or too little bicarb?

too little

Metabolic Alkalosis: Too much or too little hydrogen?

too little

Respiratory Alkalosis: Too little or too much CO2 in the body?

too little

Metabolic Acidosis: Too much or too little hydrogen?

too much

Metabolic Alkalosis: Too much or to little bicarb?

too much

Respiratory Acidosis: Too much or too little CO2 in the body?

too much

Metabolic Acidosis: Causes

-DKA -starvation -renal failure -severe diarrhea (lower GI, think losing base)

Metabolic Acidosis: Signs/Symptoms

-depend on the cause -hyperkalemia -increased resp. rate (Kussmaul respirations)

Metabolic Alkalosis: Signs/Symptoms

-depends on cause -observe LOC -serum potassium will go down -monitor for muscle cramps & life-threatening arrhythmias

Respiratory Acidosis: Treatment

-fix the breathing problem -with pneumonia: liquefy & mobilize secretions -with pneumothorax: chest tubes -encourage turn, cough and deep breathe (TCDB)

Metabolic Alkalosis: Treatment

-fix the problem -replace potassium

Respiratory Acidosis: Signs/Symptoms

-headache -confused -sleepy -could lead to coma -hypoxic as acid increases, LOC goes down

Respiratory Alkalosis: Causes

-hyperventilation -hysterical situation -acute aspirin overdose (stimulates the resp. system)

Respiratory Alkalosis: Signs/Symptoms

-lightheaded -faint feeling -peri-oral numbness -numbness and tingling in fingers and toes

Metabolic Alkalosis: Causes

-loss of upper GI contents; upper GI think acid, losing acid -too many antacids (too much bicarb)

Respiratory Alkalosis: Treatment

-may have to sedate client to decrease resp. rate -treat the cause -monitor ABGs

Metabolic Acidosis: Hyperkalemia manifestations

-muscle twitching -muscle weakness -flaccid paralysis -arrhythmias

Normal HCO3 (bicarb) range

22-26

Normal PaCO2 range

35-45

Normal pH range

7.35-7.45

Normal PaO2 range

80-100

Major lung chemical

CO2

Metabolic Acidosis: What chemical will the lungs compensate with?

CO2

Respiratory Acidosis: What chemical is causing the problem?

CO2

Respiratory Alkalosis: What chemical is causing the problem?

CO2

What chemical will the lungs compensate with?

CO2

Respiratory Acidosis: Hypoventilating or hyperventilating?

Hypoventilating

Metabolic Acidosis: Why does DKA and starvation cause metabolic acidosis?

The cells are starved because glucose is not available. The body will break down fat for energy. As a result of fat breakdown, ketones are produced causing acidosis.

Bicarbonate is

a base

Partially compensated means the pH is

abnormal

Hypoventilation can lead to

acidosis

Hyperventilation can lead to

alkalosis

CO2 is

an acid

Hydrogen is

an acid

Metabolic Acidosis: Which kidney chemicals are causing the problem?

bicarb & hydrogen

Metabolic Alkalosis: Which kidney chemicals are causing the problem?

bicarb & hydrogen

Kidney chemicals are

bicarb and hydrogen

Respiratory Acidosis: The kidneys are compensating with what chemicals?

bicarb and hydrogen

Respiratory Alkalosis: Kidneys are compensating with what two chemicals?

bicarb and hydrogen

The kidneys remove excess acid and ___________ by

bicarb; excreting them through the urine

What can occur if the pH is messed up

coma

Increased CO2 equals

decreased LOC and decreased O2

A person can __________ from acidosis or alkalosis making them _________ _____________ clients

die; high-priority

An alkalotic person is

excitable

Respiratory Acidosis: The body must ___________ hydrogen and ___________ bicarb

excrete; retain

Respiratory Alkalosis: The body will _________ bicarb and __________ the hydrogen

excrete; retain

Metabolic Alkalosis: pH high or low?

high

Respiratory Alkalosis: pH high or low

high

The kidneys can retain ___________ and ____________ and return to the blood

hydrogen; bicarb

Metabolic acidosis equals

hyperkalemia

Respiratory Alkalosis: Hyperventilating or hypoventilating?

hyperventilating

Metabolic alkalosis equals

hypokalemia

Metabolic Acidosis: Respiratory rate will ___________ to get rid of acid

increase

An acidotic person is

lethargic

Respiratory Alkalosis: Gaining or losing CO2?

losing

Metabolic Acidosis: pH low or high

low

Respiratory Acidosis: Is the pH high or low?

low

Metabolic Acidosis: Which organ is going to compensate?

lungs

Metabolic Alkalosis: Which organ is going to compensate?

lungs

Respiratory Acidosis: Which organ has a problem?

lungs

Respiratory Alkalosis: Which organ has a problem?

lungs

Full compensated means the pH is

normal

Early signs and symptoms of hypoxia?

restlessness and tachycardia

Respiratory Acidosis: Causes

retain CO2 -mid-abdominal incision -narcotics -sleeping pills -pneumothorax -collapsed lung -pneumonia

What responds first during a pH imbalance?

the lungs; the kidneys can take hours to days to do their job

Metabolic Acidosis: Treatment

treat the cause

Serum potassium will go ____________ in metabolic acidosis and go __________ in metabolic alkalosis.

up; down