Principles of Human Acid-Base Regulation and Balance

What is the primary objective of the body maintaining a balance between acids and bases?

To achieve homeostasis.

Which three specific health problems are listed as leading to acid-base imbalances?

Diabetes, Chronic Obstructive Pulmonary Disease (COPD), and kidney disease.

How does the concentration of H+ ions relate to the acidity of a solution?

An increase in H+ concentration leads to increased acidity.

A decrease in H+ concentration results in which chemical state?

Alkalinity.

What is the slightly alkaline pH range of normal human blood?

7.35 to 7.45.

Blood pH levels below 7.35 are clinically defined as _____.

Acidosis

Blood pH levels exceeding 7.45 are clinically defined as _____.

Alkalosis

According to the pH scale, at what pH values does death typically occur?

Below 6.8 or above 7.8.

What is the normal ratio of carbonic acid to base bicarbonate required to maintain a normal pH?

1 part carbonic acid to 20 parts base bicarbonate.

Identify the three primary mechanisms the body uses to regulate acid-base balance.

The buffer system, the respiratory system, and the renal system.

Which mechanism acts as the primary, immediate regulator of acid-base balance?

The buffer system.

How do buffer systems chemically protect the pH of the body?

By changing strong acids into weak acids or binding acids to neutralize them.

The buffer system requires the adequate functioning of which two other systems to be effective?

The respiratory and renal systems.

Chemical Equation: Carbonic Acid/Bicarbonate Buffer reaction with $HCl$

HCl + NaH2CO3 →NaCl + H2CO3

What are the four 'other' buffer systems mentioned besides the carbonic acid-bicarbonate system?

Phosphate, protein, hemoglobin, and cellular buffer systems.

In the cellular buffer system, H+ ions shift in and out of the cell in exchange for which ion?

Potassium (K+).

Arterial blood gas (ABG) values provide objective information regarding which three clinical factors?

Acid-base status, the underlying cause of imbalance, and the body's ability to regulate pH.

Besides pH, what two oxygen-related values are measured in an ABG analysis?

Partial pressure of arterial O2 (PaO2) and O2 saturation.

Normal Value: Arterial pH

7.35 - 7.45

Normal Value: PaCO2

35 - 45 mmHg

Normal Value: PaO2

80 - 100 mmHg

Normal Value: HCO3

21 - 28 mEq/L

Normal Value: Arterial Lactate

3 - 7

Formula: Anion Gap

Anion Gap Na+ - (HCO3- + Cl-)

What is the normal range for a calculated anion gap?

8 - 12 mmol/L.

Condition: Respiratory Acidosis (Compensatory Mechanism)

The kidneys excrete acid (a relatively slow process).

Condition: Metabolic Acidosis (Compensatory Mechanism)

The lungs increase the rate of CO2 elimination (a rapid process).

What are the primary implementation goals for treating respiratory acidosis?

Improving gas exchange via drug therapy, oxygen therapy, and ventilatory support.

How is metabolic acidosis specifically treated when caused by Diabetic Ketoacidosis (DKA)?

Through the administration of insulin.

What treatments are used for metabolic acidosis resulting from prolonged diarrhea?

Rehydration and antidiarrheals.

Respiratory alkalosis is characterized by a deficit in which substance?

Carbonic acid (H2CO3).

What is a primary cause of respiratory alkalosis related to acute pulmonary disorders?

Hypoxemia.

What is the clinical significance of an increased anion gap calculation?

It indicates an gain of acid in the body.

Interpretation: pH 7.28, PaCO2 2 mmHg, PaO2 70 mmHg, HCO3- 18 mEq/L

Metabolic Acidosis with partial respiratory compensation.

Interpretation: pH 7.33, PaCO2 67 mmHg, PaO2 47 mmHg, HCO3- 37 mEq/L

Respiratory Acidosis with partial renal compensation.

Expected ABG Shifts: Respiratory Acidosis

Decreased pH and increased PaCO2.

Expected ABG Shifts: Metabolic Acidosis

Decreased pH and decreased HCO3-.

Expected ABG Shifts: Respiratory Alkalosis

Increased pH and decreased PaCO2.

Expected ABG Shifts: Metabolic Alkalosis

Increased pH and increased HCO3-.

What is the specific role of oxygen therapy in the implementation plan for respiratory acidosis?

To improve gas exchange and correct hypoxemia associated with the acidosis.