Week 2

Question 1

pH range

Answer 1

7.35-7.45

Question 2

PaCO2

Answer 2

35-45 mm Hg

Question 3

HCO3

Answer 3

22-26 mEq/L

Question 4

PaO2

Answer 4

80-100 mm Hg

Question 5

kidneys regulate ____ in the ECF

Answer 5

bicarbonate

Question 6

lungs regulate ___ and thus the carbonic acid in ECF

Answer 6

CO2

Question 7

the more hydrogen ions there are, the ___ the pH =more acidic

Answer 7

lower

Question 8

____ production of bicarbonate is the most common in the body

Answer 8

pancreatic

Question 9

Acid-Base buffer system: 1st action

Answer 9

protein and chemical buffers- within seconds

Question 10

Acid-Base Buffer system: 2nd action

Answer 10

respiratory system- within minutes to hours

*carbonic acid system and respiratory

Question 11

Acid-Base Buffer system: 3rd action

Answer 11

Kidneys and Bicarbonate- within hours to days

Question 12

Increased CO2 = _____ventilation

Answer 12

hyper

Question 13

decrease free H and decreased CO2= ____ventilation

Answer 13

hypo

Question 14

carbonic anhydrase equation

Answer 14

20:1 keeps pH normal
20 parts Bicarb to 1 carbonic acid

Question 15

Kidneys excrete extra hydrogen and/or reabsorb ___ to ___ pH

Answer 15

bicarb; balance

Question 16

If pH ____ the kidneys retain HCO3

Answer 16

decreases

Question 17

If pH increases, the kidneys ______ HCO3

Answer 17

excrete

Question 18

pH= kidney function= Bicarb levels- ___

Answer 18

slow

Question 19

Lung function= Carbon Dioxide level- ___

Answer 19

rapid

Question 20

ROME

Answer 20

Respiratory
Opposite
Metabolic
Equal

Question 21

think respiratory with ____

Answer 21

carbon dioxide CO2

Question 22

think metabolic with ___

Answer 22

bicarb HCO3

Question 23

Respiratory: high CO2 = ____ pH

Answer 23

low

Question 24

Metabolic: High Bicarb = ___ pH

Answer 24

high

Question 25

calcium binds better be ___ pH

Answer 25

high

Question 26

metabolic acidosis= ___kalemia

Answer 26

hyper

Question 27

4 main causes of metabolic acidosis

Answer 27

**overproduction of hydrogen ions**-aspirin, alcohol **under elimination of hydrogen ions**- kidney failure, severe lung disease **under production of bicarb ions**- kidney/pancreas related **overelimination of bicarb ions**- diarrhea

Question 28

anion gap normal range

Answer 28

8-12 mEq/L

Question 29

what is the definition of anion gap

Answer 29

difference between the sum of cations (+) and anions (-) in the blood

Question 30

<8 anion gap indicates

Answer 30

base accumulation

Question 31

>12 anion gap indicated

Answer 31

acid accumulation

Question 32

>16 anion gap indictaes

Answer 32

excessive unmeasured anions in the blood

Question 33

"open/positive/elevated" anion gap is great than ___ (numerical)

Answer 33

12

Question 34

what causes a large gap? (anion)

Answer 34

accumulation of hydrogen

Question 35

metabolic acidosis clinical manifestations

Answer 35

-Headache, confusion, drowsiness, increased RR and depth, nausea, vomiting -Cold clammy skin, dysrhythmias and shock -Vasodilation, decreased BP and decreased CO s/s increased potassium and increased free calcium

Question 36

assessment and diagnostics for metabolic acidosis

Answer 36

pH <7.35 bicarbonate <22 hyperkalemia

Question 37

Acute Metabolic Acidosis: DKA No insulin present to turn ____ into fuel

Answer 37

glucose

Question 38

Acute Metabolic Acidosis: DKA No glucose mean the body breaks down ___ for fuel which creates ____ as a waste product

Answer 38

fat; ketones

Question 39

Acute Metabolic Acidosis: DKA Person is in a persistent ____ state from the _____

Answer 39

acidotic; ketones

Question 40

Acute Metabolic Acidosis: DKA Need the ___ ___ to close before stopping ____

Answer 40

anion gap; insulin

Question 41

Acute Metabolic Acidosis: DKA s/s

Answer 41

High Blood Sugar and Urine Ketones Excessive Thirst, Frequent Urination, N/V, Fatigue, Confusion, Fruity Breath Severe Electrolyte Imbalance Kussmaul breathing- deep rapid breathing

Question 42

Respiratory Acidosis: Retention of CO2 based on 4 causes

Answer 42

respiratory depression inadequate chest expansion airway obstruction reduced alveolar capillary diffusion

Question 43

Respiratory Acidosis: Assessment and Dx

Answer 43

low pH <7.35 PaCO2 >45mm Hg Chest xray

Question 44

Respiratory Acidosis:: Clinical manifestations

Answer 44

changes in breathing pattern and LOC

Question 45

Respiratory Acidosis: Medical management

Answer 45

Treatment aimed at improving ventilation: -Bronchodilators, antibiotics, thrombolytic -Pulmonary Toileting/Hygiene -Semi Fowlers positions -Mechanical ventilation

Question 46

Acute Respiratory Acidosis causes

Answer 46

narcotics myasthenia gravis, MS ingestion of foreign object Pulmonary hygiene/pneumonia -atelectasis= when smaller lung fields collapse

Question 47

Alkalosis: Hypo-?

Answer 47

Hypo- calcemia, chloremia, kalemia

Question 48

Acute/Chronic Metabolic Alkalosis: Most common cause

Answer 48

vomiting or gastric suction

Question 49

Acute/Chronic Metabolic Alkalosis: other causes

Answer 49

long term diuretic use hypokalemia

Question 50

Acute/Chronic Metabolic Alkalosis: Assessment & Dx

Answer 50

high pH > 7.45 high bicarb >26 mEq/L urine chloride

Question 51

Acute/Chronic Metabolic Alkalosis: Clinical Manifestations

Answer 51

*Symptoms related to decreased calcium*: Tingling of the fingers and toes, dizziness and hypertonic muscles Respiratory depression (due to compensation), atrial tachycardia, decreased gastric motility and paralytic ileus *Symptoms of hypokalemia* Muscle weakness, flattened t-wave, u-wave, decreased bowel sounds, fatigue

Question 52

Acute and Chronic Respiratory Alkalosis: Patho

Answer 52

Always due to hyperventilation- extreme anxiety, inappropriate ventilator settings, hypoxemia, chronic hypocapnia

Question 53

Acute and Chronic Respiratory Alkalosis: Dx Findings

Answer 53

High pH >7.45 PaCO2 <35 mm Hg

Question 54

Acute and Chronic Respiratory Alkalosis: Clinical Manifestations

Answer 54

lightheadedness, inability to concentrate, numbness and tingling, Decreased cerebral blood flow with sometimes loss of consciousness Tachycardia, atrial and ventricular arrhythmias

Question 55

Acute and Chronic Respiratory Alkalosis: Medical Management

Answer 55

paper bag breathing anti-anxiety ventilator setting changes

Question 56

Metabolic and respiratory acidosis during ___ ___

Answer 56

cardiac arrest

Question 57

PaCO2 alkalosis value

Answer 57

<35 mmHg hyperventilation- not enough retained

Question 58

PaCO2 acidosis value

Answer 58

>45 mmHg hypoventilation

Question 59

Bicarb HCO3 alkalosis value

Answer 59

>26

Question 60

Bicarb HCO3 acidosis value

Answer 60

<22

Question 61

Normal range HCO3

Answer 61

22-26 mEq/L

Question 62

PaO2 normal range

Answer 62

80-100 mmHg