blood gas

low ph

acidic

high ph

basic (alkaline)

how do lungs control acid/base balance

co2 (acidic) is exhaled

how do the kidneys control acid/base balance?

kidneys excrete H+ (acidic) ions in urine and retain bicarbonate

what is compensation?

opposite system will try to compensate for high/low ph

normal ph

7.35-7.45

normal pco2

35-45 mmhg

normal hco3

21-28 mEq/L

respiratory acidosis symptoms

• rapid, shallow respirations

• dyspnea

• hyperkalemia

causes of respiratory acidosis

• COPD

• pneumonia

• atelectasis

• decreased respiratory stimuli (anesthesia, drug overdose)

how can hyperkalemia occur with respiratory acidosis

blood is too acidic, H+ ions will move out of blood and into the cell, which causes potassium to shift out

respiratory alkalosis symptoms

• deep, rapid. breathing

• hyperventilation

• tachycardia

• hypokalemia

• lethargy/confusion

causes of respiratory alkalosis

• hyperventilation (anxiety, PE)

• mechanical ventilation

how can hypokalemia occur with respiratory alkalosis?

H+ leaves cell and enters bloodstream as blood is too basic, with shifts potassium into the cell

metabolic acidosis symptoms

• headache

• decreased by

• hyperkalemia

• muscle twitching

• warm, flushed skin

• N+V, diarrhea

causes of metabolic acidosis

• DKA (buildup of ketones)

• severe diarrhea (losing bicarb)

• renal failure (unable to urinate H+)

• shock (hypoperfusion of muscles, lactic acid buildup)

metabolic alkalosis symptoms

• lethargy

• tachycardia

• hypoventilation

• confusion

• N+V, diarrhea

• hypokalemia

• tingling of extremities

causes of metabolic alkalosis

• severe vomiting

• excessive GI suctioning (NG)

• diuretics (losing too much H+ in urine)

• excessive NaHCO3 (tums)