acid base imbalance!!

what do chemical reactions in the body need?

proper balance of acids and bases

acid-base balance =

homeostasis of H+ ion concentration

what are acids?

substances containing H+ that can be released

what is carbonic acid?

H2CO3

what is a base?

substances that can trap H+

bicarbonate?

HCO3-

what is pH?

expression of H+ ion concentration

acidic on pH scale?

highest 1-6 lowest

neutral on pH scale?

7

base on pH scale?

lowest 8-14 highest

pH of normal blood plasma?

7.35 to 7.45

pH of gastric secretions?

1 to 1.3

pH of pancreatic fluid and bile?

7.8 to 8

pH of urine?

5 to 6

pH of cerebrospinal fluid?

7.28 to 7.32

describe blood pH of 6-7?

death

describe blood pH of 7-7.35?

acidosis

describe blood pH of 7.45-7.8?

alkalosis

describe blood pH of 7.8-9?

death

describe acidosis H+?

excessive H+ ions

describe acidosis bicarbonate?

loss

ph of acidosis?

less than 7.35

describe alkalosis H+?

loss of H+ ions

describe alkalosis bicarbonate?

excess bicarbonate

pH of alkalosis?

greater than 7.45

what does a buffer do?

works to keep the pH normal in the body

what are the three buffer systems?

carbonic acid - sodium bicarbonate buffer, phosphate buffer system, protein buffer system

what is the body's most important buffer system?

carbonic acid - sodium bicarbonate buffer

what is the ratio of bicarbonate to carbonic acid ratio in extracellular fluid?

20:1

what does the carbonic acid - sodium bicarbonate buffer do for the lungs?

regulates the production of carbonic acid

what does the carbonic acid - sodium bicarbonate buffer do for kidneys?

regulates the production of bicarbonate

if you breathe faster than your pH....

increases

where is the phosphate buffer system active?

in the renal tubules

what occurs in the phosphate buffer system?

phosphate binds with acids or bases to alter the pH

what is the protein buffer system do?

plasma proteins and globin combine with H+ to alter pH

what can the respiratory system rapidly do?

can rapidly alter the bodies pH but effects are short term

what is an end product of cellular metabolism?

carbon dioxide

what do the lung excrete?

CO2

if you are trying to get ride of acid what should you do?

breathe deeper and faster

in the assessment of acid base balance what should be assessed and what is measured?

arterial blood gases. measures pH, PaCO2, PaO2, HCO3-

what is there a deficit in in metabolic acidosis?

deficit of bicarbonate

what does metabolic acidosis result from?

from a loss of bicarbonate or excessive acid

metabolic acidosis =

low pH and low HCO3

what are causes of metabolic acidosis?

-diarrhea

-intestinal fistulas

-parenteral nutrition

-excessive intake of acids

-diabetic ketoacidosis

-renal failure

-starvation ketoacidosis

what are the nursing interventions for metabolic acidosis?

correct metabolic deficit. bicarbonate may need to be administered.

what is there an excess in in metabolic alkalosis?

excess of bicarbonate

what may metabolic alkalosis be related to?

acid loss or increased base consumption

metabolic alkalosis =

high pH and high bicarbonate

what are the causes of metabolic alkalosis?

-vomiting

-gastric suction

-hypokalemia

-potassium: wasting diuretics

-alkali ingestion

-renal loss of H+ ions: steroids, diuretics

what are the treatments for metabolic alkalosis?

treatment of underlying disorders. administering fluids. monitoring electrolytes: adequate chloride in the body is needed to excrete bicarbonate

what is their an excess in in respiratory acidosis?

carbonic acid

what does respiratory acidosis result from?

inadequate ventilation

respiratory acidosis =

low pH and high PaCO2

what are the causes of respiratory acidosis?

-acute and chronic respiratory disease

-pulmonary edema

-foreign body aspiration

-overdose of sedative

-cardiac arrest

-inadequate mechanical respiration

-CNS depression

-neuromuscular disorders

what are the nursing interventions for respiratory acidosis?

goal is to improve respiration. pulmonary hygiene. adequate hydration. providing oxygen as needed.

what is their a loss or deficit in in respiratory alkalosis?

loss or deficit of carbonic acid

what does respiratory alkalosis result from?

hyperventilation

respiratory alkalosis =

high pH and low PaCO2

what are causes of respiratory alkalosis?

-hyperventilation

-extreme anxiety

-hypoxemia

-high fever

-early sepsis

-excessive viltration

-CNS lesions affecting the respiratory center

what are the nursing interventions of respiratory alkalosis?

encourage client to breath slowly or breathing into a close system. sedative may be needed

if all three are irregular than...

partially compensated

if two are abnormal and one of them is pH then...

uncompensated

if two are abnormal and neither is pH then...

compensated

what does compensation do?

adjusts the pH

what is partial compensation?

pH remains outside of normal range

what is complete compensation?

pH falls within normal range