1
Q
What causes an increase in acid production?
A
- Excessive oxidation of fatty acids
- Hypermetabolism
- Excessive ingestion of ethanol and salicylate
2
Q
What causes excessive oxidation of fatty acids?
A
- Starvation
- Ketoacidosis
3
Q
What causes hyper metabolism?
A
- Exercise
- Seizures
- Fever
- Ischemia
4
Q
What causes an increase in acid loss?
A
- Vomiting
- Gastric suctioning
5
Q
What causes a decrease in acid excretion?
A
- Renal failure
6
Q
What causes bicarbonate loss or underproduction?
A
- Diarrhea
- Excessive ileostomy drainage
- Pancreatitis
- Liver failure
7
Q
What causes an increase in bicarbonate?
A
- Alkaline ingestion
- Excessive sodium bicarbonate administration
8
Q
What causes increased/decreased levels of CO2?
A
- Respiratory conditions
- Opiate overdose
- Anxiety
- Fever
- COPD
- Inadequate chest expansion
9
Q
Normal pH levels
A
7.35 - 7.45
10
Q
Normal PaCO2
A
35 - 45 mmHg
11
Q
Acidotic PaCO2
A
<35 mmHg
12
Q
Alkalotic PaCO2
A
> 45 mmHg
13
Q
Normal HCO3
A
22 - 28 mEq/L
14
Q
Acidotic HCO3
A
<22 mEq/L
15
Q
Alkalotic HCO3
A
> 28 mEq/L
16
Q
Normal PaO2
A
80 -100 mmHg
17
Q
Normal SaO2
A
> 95%
18
Q
Respiratory acidosis
A
- Increased CO2
- Decreased pH
19
Q
Causes of respiratory acidosis
A
- Hypoventilation
- Decreased respiratory drive/respiratory depression
- Neuromuscular disorders
- Airway obstruction/alveolar capillary exchange
20
Q
Respiratory alkalosis
A
- Increased pH
- Decreased PaCO2
21
Q
Metabolic alkalosis
A
- Increased pH
- Increased HCO3
22
Q
- Causes of metabolic alkalosis
A
- Loss of gastric acid
- Loss of K+
- Cushing’s syndrome
- Ingestion of excess antacids, baking soda
- IV administration of bases
23
Q
Examples of loss of gastric acid
A
- Severe vomiting
- Nasogastric suctioning
- Gastric fistulas
24
Q
Examples of K+ loss
A
- Excessive diuretic therapy
25
Examples of IV administration of bases
- Sodium bicarbonate
- TPN
- Lactate in Ringer's lactate
- Citrate in massive amounts of blood transfusions
26
Metabolic alkalosis vitals
- Tachycardia
- Normal - hypotensive BP
27
Metabolic alkalosis respiratory s/s
- Hypoventilation
28
Metabolic alkalosis near s/s
- Irritable
- Lethargic
- Confused
- Headache
29
Metabolic alkalosis neuromuscular s/s
- Tetany
- Tremors
- Numbness/tingling in fingers/toes
- Muscle cramps
- Hyperactive reflexes
- Seizures
30
Metabolic alkalosis cardiac s/s
- dysrhythmias r/t hypokalemia
31
Electrolyte problems associated with metabolic alkalosis
- Hypokalemia
- Hypochloremia
- Hypocalcemia
32
Metabolic acidosis causes
- DKA
- Starvation
- Alcoholism
- Rhabdomyolysis
- Ingestion of aspirin/salicylates
- Chronic renal failure
- Severe lung problems
- Prolonged diarrhea
- Pancreatitis
33
Metabolic acidosis vitals
- Bradycardia
- Hypotension
- Tachypnea
34
Metabolic acidosis cardiac s/s
- Dysrhythmias
- Possible cardiac arrest
35
Metabolic acidosis respiratory s/s
- Kussmaul respirations
- Deep, rapid respirations
36
Metabolic acidosis neuro s/s
- Lethargic
- Confused
- Dizziness
- Headache
- Decreased LOC, stupor, coma
37
Metabolic acidosis GI s/s
- N/V/D
- Abdominal pain
38
Metabolic acidosis neuromuscular s/s
- Muscle Weakness
39
Metabolic acidosis skin s/s
- Cold
- Clammy
40
Normal anion gap
8 - 12 mol/L
41
DKA labs
- Hyperglycemia >250
- AGAP open >12
- Metabolic acidosis
- Serum HCO3 <18
- Electrolyte imbalances
42
DKA triggers
- Infections
- Pregnancy
- Insufficient/missed insulin
- Trauma/emotional stress/surgery
- MI
- Exercise
- Alcohol abuse
- Medications
43
What infections are common triggers for DKA?
- PNA
- UTI
- Sepsis
- Pancreatitis
44
What medications are common triggers for DKA?
- Corticosteroids
- Thiazide diuretics
- Atypical antipsychotics
45
DKA s/s
- Polydipsia
- Polyuria
- Polyphagia
- N/V
- Blurred vision
- Weakness/lethargy
- Fruity/rotting fruit breath
- Kussmaul respirations
46
DKA vital signs
- Tachycardia
- Hypotension
- Tachypnea
47
DKA neuro s/s
- Change in mental status
- Malaise
- Lethargy
48
DKA integumentary s/s
- Warm
- Dry
- Flushed
49
DKA GI s/s
- N/V
- Weight loss
- Increased thirst
- Fruity breath
50
DKA GU s/s
- Increased urination
- Significant dehydration
51
DKA
