acid/bases

Define acid

A substance that increases hydrogen ions because it gives up its proton

Define bases

A substance that increases the concentration of hydroxyl ions in water because it received protons

What are the two body organs that help with acids/bases 

Lungs by blowing it off and kidneys by peeing it out 

Is CO2 an acid or base?

Acid 

Does breathing fast blow off more CO2 or retain it?

Blow more CO2 off 

Does breathing slower blow more acid off or keep more acid?

Keep more acids 

What is the pH scale for?

A state or equilibrium between acidity and alkalinity of body fluids, resulting in a stable concentration of hydrogen ions 

Is 0-6 acidic, neutral or alkaline?

Acidic

Is 7 acidic, neutral or alkaline?

Neutral 

Is 8-14 acidic, neutral or alkaline?

Alkaline

How do you measure pH?

pH of 4 is 2 times more acidic than 6 so you would do 10 to the second power = 100

Is .5 a huge difference in either direction in pH?

yes, this is a huge change that is not conductive to life 

shifts in pH of body fluids are controlled by 3 major regulatory systems… what are they?

-biological (blood and cellular activity)

-chemical (the 3 buffer system) 

-physiologic (the lungs and kidneys)

what are the three CHEMICAL regulations?

-bicarbonate buffer systems 

-protein buffer system

-phosphate buffer systems

what is the biological regulators concerned about?

the shifting of excess acid and alkali in and out of the cells. ions cross over the cell membrane BUT they have to do this with ions of the same charge OR combination with opposite charge

as chloride leaves the oxygenated blood cells and enters the plasma, what happens?

the bicarbonate moves from the plasma and crosses into the cellular fluid

sodium-potassium ion pump is an example of what regulatory system?

biological regulatory

the carbonic acid-bicarbonate buffer system regulates pH of blank

blood

what does the protein buffer system depend on?

the ability of amino acids in protein chair to react to changes in pH

what does the phosphate buffer system do?

limited in ECF, has a major role in stabilizing pH of urine

which buffer system is the fastest and quickest way to maintaining acid-base buffer?

carbonic acid-bicarbonate buffer system

whats the ratio of carbonic acid and bicarbonate?

1:20

how fast does the carbonic acid-bicarbonate system work?

instantly but they absorb rapidly

how fast does the repsiratory buffer system work?

1-3 minutes

how does the respiratory buffer system work?

triggered by chemoreceptors in the respiratory centers of the brain stem that detect pH in the cerebrospinal fluid

once the respiratory buffer system detects the pH, what happens?

decides whether it needs to keep the CO2 or let it go.

if acidosis is present- respiratory activity INCREASES or DECREASES so that the PaCO2 FALLS or RETAINED 

increases, fall

if alkalosis is present- respiratory activity INCREASES or DECREASES so that the PaCO2 FALLS or RETAINED 

decreases, retained

is the renal buffer system fast or slow?

slow, could take hours to days

the kidneys act as regulators by…

-reabsorbing or excreting bicarbonate

-reabsorbing or excreting hydrogen

what causes respiratory acidosis?

-retention of CO2 so CO2 is raised

-pH is going to decrease (because CO2 is acidic)

clinical presentation of respiratory acidosis

-ams

-tachycardia

-diaphoresis

-headache

-cardiac dysrhythmias

-abnormal breathing

respiratory acidosis medical problems

-crappy or no respirations 

-COPD 

-overdose 

-pneumonia 

-smoke inhalation 

-pneumothorax

-airway obstruction

ALL of these cause a retention of CO2. CO2 is respiratory and CO2 is an acid meaning… respiratory acidosis 

treatment for respiratory acidosis

-improve their ventilations either by bagging them or having them breath more

what causes respiratory alkalosis?

-excessive elimination of CO2 (so blowing too much CO2 off and getting rid of your acids)

-pH is increased 

-CO2 is decreased 

respiratory alkalosis clinical presentation

-numbness of fingers/hands

-seizures 

-ams

-carpopedal spasm 

-anything muscular

respiratory alkalosis causes

-anxiety

-pain

-fever

-hyperventilation

-hypotension

-CHF

treatment for respiratory alkalosis

-slow down their breathing

-calm them down (especially anxiety people)

what causes metabolic acidosis?

-production of metabolic acids

-pH decreases 

-HCO3 decreases (due to a decrease in bicarbonate elimination)

if pH and HCO3 are both acidic/decreased its automatically metabolic acidosis  

metabolic acidosis clinical presentation

-tachycardia

-pulmonary edema 

-deep breathing, tachypnea 

-confusion 

metabolic acidosis medical causes

-cardiac arrest

-renal failure 

-DKA 

-sepsis 

-asa or antifreeze OD 

-diarrhea (assidosis)

-hypotension

treatment for metabolic acidosis

-increase ventilation so if youre bagging for them, bag faster to eliminate CO2

-sodium bicarb to help increase  

what causes metabolic alkalosis?

-too much bicarbonate 

-pH is increased 

-HCO3 is increased 

if your pH and HCO3 is increased/alkalosis its automatically metabolic alkalosis

clinical presentation of metabolic alkalosis?

-seizures 

-headache

-dysrhythmia 

-abnormal breathing

-vomiting (vomiting all the acid)

causes of metabolic alkalosis

-diuretics 

-vomiting 

-chewing tobacco 

-penicillin 

-giving too much bicarb

treatment for metabolic alkalosis

-keep them alive long enough to get to the hospital

what is ABG

arterial blood gas, blood test from the artery that tells pH, CO2 and HCO3

normal pH levels

7.35-7.45

normal PaCO2 levels

35-45 mmHg

normal PaO2 levels

90%-100%

normal HCO3 levels

22-26 mEq/1

if pH 7.49, is it compensated alkalosis or acidosis?

alkalosis due to it being > 7.4

if pH is 7.39, it compensated alkalosis or acidosis?

acidosis due to it being < 7.4

vomiting

metabolic alkalosis

DKA

metabolic acidosis

diarrhea

metabolic acidosis

renal failure

metabolic acidosis

diuretic use

metabolic alkalosis

antacid use 

metabolic alkalosis

severe dehydration

metabolic acidosis

sepsis

metabolic acidosis

copd

respiratory acidosis 

drug overdose

respiratory acidosis

pneumonia

respiratory acidosis

hyperventilation

respiratory alkalosis