acid base balance

what is a acid?

any compound that contains hydrogen ions that can be released (H+)- cations

what is a base?

a substance that reduces the hydrogen ion concentration of a solution- anions

why are acid base balances important?

must be maintained to support life

what is the pH scale?

a measure of how many free H+ ions there are in a solution- 0 is acidic and 14 basic, 7 is neutral

what is the normal pH of the body?

between 7.35 to 7.45

what pH is compatible for life?

6.8 to 7.8

what are acids in the body?

CO2, lactic acids, HCL, Ketones (waste from the breakdown fo fat)

what are bases in the body?

HCO3 (bicarb)- kidneys retain or excrete tu=his

what are buffer systems?

systems that prevent wide swings in the pH- consists of a weak acid and a weak base.

what is the carbonic acid-sodium bicarb system?

the balance of carbon dioxide (acid) and bicarb (base)- the respiratory mechanism is the fastest but renal mechanism is the most powerful

what is the respiratory mechanisms?

detects acid base balance- can slow breathing too basic and can quicken breathing if tis too acidic

what is the renal mechanism?

can excrete or absorb bicarb to regulate balance

what is the phosphate buffer system?

regulates balance in the intracellular fluid- can convert alkaline sodium phosphate to acid sodium phosphate

what is the protein buffer system?

proteins and globin portions of hemoglobin contain chemical groups that can combine with or free hydrogen ions to maintain balance

what is hydrogen?

a cation that makes things acidic

-more H+= lower pH= acidosis

-less H+= higher pH= alkalosis

what is potassium?

-mostly lives in the cells

-in acidosis too much H+ builds in the blood: H+ pushes into the blood, K moves out of the cell resulting in hyperkalemia

what is chloride?

an anion that helps balance the charge when other anions move: when bicarb leaves the blood, chloride replaces it to maintain balance, when the body losses too much chloride with vomiting it keeps bicarbonate resulting in alkalosis

what is arterial blood gas?

Blood taken from arteries, testing for arterial gases like O2 and CO2 and pH

how is ABG taken?

blood is taken from an artery in the wrist and should fill up the syringe without using the plunger syringe- it is very painful

what is the ideal range of pH?

7.35 to 7.45 (7.4 is the most ideal)

what is the ideal range of PaCO2?

35-45

what is the ideal range of HCO3 (bicarb)?

22-26

what is the ideal range of partial pressure oxygen saturation?

80-100

what does the acronym ROME mean?

Respiratory Opposite Metabolic Equal

what is uncompensated ABG?

the body does not recognize an imbalance and therefore has not yet done anything to balance the imbalance

what is partial compensation ABG?

the body recognizes the imbalance and starts to rectify the imbalance but it is still imbalanced

what is fully compensation ABG?

the body returns to homeostasis - it doesn't fix the problem/what caused it but can return to homeostasis

what causes respiratory acidosis?

-can be caused by decreased respiratory rates resulting in a build up of CO2

-COPD, asthma, pulmonary edema, cystic fibrosis, CNS depression, overdose and aspiration on a foreign object

what are symptoms of respiratory acidosis?

mental cloudiness, fatigue, dizziness, headache, skin warm and flushed, increased pulse and RR (to compensate), muscle twitching, hyperkalemia (H+ in the cell to balance pH but K is pushed out

what are interventions for respiratory acidosis?

institute measures to improve gas exchange, such as chest physiotherapy, bronchodilators, and antibiotics. Provide supplemental oxygen and maintain hydration

what is the cause of respiratory alkalosis?

-increased respiration rate:

-hyperventilation, anxiety, brain tumor, CVA, high fevers, early sepsis

what are the symptoms of respiratory alkalosis?

inability to concentrate, lightheadedness, tachycardia, shallow respirations, dizziness and blurred vision

what is the interventions for respiratory alkalosis?

-relaxation, slow breathing, treat and identify the underlying conditions

what are the causes of metabolic acidosis?

-renal failure (the kidneys cannot hold or excrete bases)

-diarrhea (base to butt), intestinal fistulas, intake of excess acid, diabetic ketoacidosis (ketones are released from the breakdown of fat), starvation (ketones and lactic acid)

what are symptoms of metabolic acidosis?

headache, confusion, increased respirations (kussmauls breathing), nausea, vomiting, fatigue, drowsy, hyperkalemia

what is the interventions for metabolic acidosis?

-correct imbalance by correcting underlying problem (DKA insulin and hydrate)

what are causes of metabolic alkalosis?

excessive acid loss due to vomiting or gastric suction, hypokalemia, potassium wasting diuretics and the ingestion of alkali substances like tums

what are symptoms of metabolic alkalosis?

dizziness, paresthesia, tingling and decreased RR rate to compensate.

what is the treatment of