Acid Base

Question 1

Base

Answer 1

Accept H ions

Question 2

Carbohydrate metabolism

Answer 2

(CO2) carried in plasma as carbonic acid

Question 3

CO2 in plasma..

Answer 3

Becomes bound with water making it carbonic acid.

-binding of water is how it gets its H ion

Question 4

Metabolism of fats

Answer 4

Ketoacids

Question 5

Metabolism of proteins

Answer 5

Sulfuric acid

Question 6

Tissue hypoxia

Answer 6

Lactic acid

-anabolic process

Question 7

Cell destruction

Answer 7

Ex.chemotherapy

- acids get released from inside of cells into the plasma

Question 8

Fixed acids

Answer 8

Ketoacids
Sulfuric acids
Lactic acids
Cell destruction

-excreted through the kidneys

Question 9

Bicarbonate

Answer 9

• weak base
• most abundant base in body
• get lots of bicarbonate through amino acids

Question 10

Ammonia

Answer 10

• strong base

- largely made in kidneys

Question 11

Normal pH

Answer 11

7.35-7.45

Question 12

Fatal pH range

Answer 12

Below 6.9 or above 7.8

Question 13

Carbonic acid to bicarbonate ratio

Answer 13

1 part carbonic acid per 20 parts bicarbonate

Question 14

Four reasons of acidosis

Answer 14

• over production of H ion
• insufficient elimination of H ion
• under production of alkali
• over excretion of alkali

Question 15

Key S/S of acidosis

Answer 15

-depressed CNS
-skeletal muscle weakness
-kussmaul respiration during metabolic acidosis
J

Question 16

4 reasons of alkalosis

Answer 16

• over production of base
• insufficient elimination of base
• underproduction of acid
• excessive elimination of acid

Question 17

Key S/S of alkalosis

Answer 17

• anxiety,irritability
• increased CNS activity
• increased HR
• low BP

Question 18

Buffer systems

Answer 18

1 rapid acting system

• take care of most mild imbalances
• reduce or increase H ions in plasma

Question 19

Bicarbonate buffer system

Answer 19

Carbonic acid system

Question 20

Phosphate buffer system

Answer 20

Most active in renal tubules

Question 21

Protein buffer system

Answer 21

Hemoglobin has ability to absorb H ions

Most common buffers

Question 22

Respiratory system

Answer 22

• controlled by the medulla
• works by only controlling CO2
• second line of defense after buffer I g systems
• can only correct imbalances for a number of hours

Question 23

Kidney regulation

Answer 23

• most powerful regulator
• can take days to regulate
• increase excretion or reabsorption of acids and bases

Question 24

Respiratory acidosis

Answer 24

• results in retention of CO2

- the kidney will excrete more H ions and hold bicarbonate

Question 25

Clinical manifestations of respiratory acidosis

Answer 25

- COPD - pneumonia - asthma - bronchitis - certain meds - broken ribs - obesity

Question 26

S/S of acute respiratory acidosis

Answer 26

- altered LOC - flushed warm skin(CO2) is a vasodilator - headache - reduced muscle tone - ineffective respirations(source of problem

Question 27

Potassium shuffle with acidosis(how body fixes it)

Answer 27

Potassium moves from inside of the cell to allow H+ ion to enter the cell Result in plasma will be more potassium, less acidity, and higher pH

Question 28

Treatment for respiratory alkalosis

Answer 28

- drug therapy: bronchodilators,anti inflammatories, mucolytics - oxygen - positioning - suction - mechanical effort -asses breathing effort and lung sounds

Question 29

Respiratory alkalosis

Answer 29

-caused by hyperventilation, leads to a decrease in CO2

Question 30

Clinical situation of respiratory alkalosis

Answer 30

- fever - pain - CVA - high altitude

Question 31

What will kidneys do to help respiratory alkalosis

Answer 31

Respond by increase excretion of bicarbonate and increase retention of H+ ions

Question 32

Potassium shuffle with alkalosis

Answer 32

Plasma potassium moves from the plasma into the cell to allow H+ ion to enter the plasma - result in plasma will be less potassium, more acidity, and lower pH

Question 33

S/S of respiratory alkalosis

Answer 33

- tachypnea - dizziness - muscle weakness - syncope -parenthesias, seizures, and hypereflexia due to hypocalcemia caused by increased pH

Question 34

Treatment of respiratory alkalosis

Answer 34

- relieve anxiety - breath more slowly - partial rebreather mask - seizure precautions - reduce fever

Question 35

Metabolic acidosis

Answer 35

-too many fixed acids lead to lower pH - diabetes poster child - anorexia, bulimia, poor diet: not taking in adequate energy sources and body breaks down fats and proteins releasing acids - renal failure

Question 36

Metabolic acidosis by lose of bases leadin to over abundance of acids

Answer 36

- diarrhea - malabsorption disorders - pancreatic disorders

Question 37

How will the lungs try to help metabolic acidosis

Answer 37

Kussmaul's respirations: deep rapid respirations

Question 38

What can kidneys due to aid in metabolic acidosis

Answer 38

Excrete H+ buffered with ammonia in the urine, retain bicarbonate

Question 39

S/S of metabolic acidosis

Answer 39

- decreased CNS - muscle weakness - hyperkalemia(more K in plasma) - Kussmaul's respirations

Question 40

Normal anion gap

Answer 40

8-14 -larger than 14 is an accumulation of acids

Question 41

Treatment of metabolic acidosis

Answer 41

* for diabetes give insulin(stops production of keytone acids) - GI loss: antidarrheals - give bicarbonate as ordered - renal failure: dialysis

Question 42

Metabolic alkalosis

Answer 42

Excessive intake or loss of acids: leads to an over abundance of base Hydrochloric acid loss: NG tube/ vomiting -loss of chloride leads to increase in bicarbonate retention in kidneys( making the situation worse)

Question 43

Metabolic alkalosis and diuretics

Answer 43

Hypocalcemia often occurs due to diuretics -this loss of potassium leads to increased H+ excretion from kidneys and results in alkalosis

Question 44

S/S of alkalosis

Answer 44

Confusion Anxiety Irritability -paresthesias, seizure, hyperreflexia due to hypocalcemia caused by increased pH

Question 45

Treatment of metabolic alkalosis

Answer 45

- decrease/ chance diuretics - acetazalomide Diamox(diuretic) to increase renal excretion of bicarbonate - decrease suctioning - control vomiting - provide chloride, potassium in IV

Question 46

Acids

Answer 46

Give away H ions