NURS350 Chapter 3 Acids Bases

Hydrogen Ion Concentration

Maintains cell membrane integrity and enzymatic reaction speed

Volatile Acid

Eliminated as CO2 gas via the lungs. Example: carbonic acid

Non-volatile Acid

Eliminated by renal tubules. Examples: sulfuric and phosphoric acid

Buffer

Absorbs excess acid without changing pH. Examples: carbonic acid bicarbonate, hemoglobin, phosphate, proteins

Carbonic Acid Bicarbonate System

Quickly decreases carbonic acid via the lungs, kidneys reabsorb or regenerate bicarbonate slowly. The more CO2, the more carbonic acid is formed. When too acidic, lungs increase respiration to eliminate CO2. Renal system excretes either acidic or alkaline urine to help balance pH.

Compensation

Restores normal blood pH without fixing cause of imbalance

Correction

Treats and fixes underlying cause for abnormal pH

Acidosis

pH <7.35. Systemic increase in hydrogen ions

Alkalosis

pH >7.45. Systemic decrease in hydrogen ions or increase in base

Respiratory Acidosis

CO2 > 45, pH <7.35. AKA hypercapnia, may result from depressed ventilation, pneumonia, COPD. Symptoms: decreased BP, headache, hyperkalemia, weakness, hyperreflexia, dizziness.

Respiratory Alkalosis

CO2 < 35, pH > 7.45. AKA hypocapnia, may result from hyperventilation. Symptoms: seizure, tachycardia, decreased BP, hypokalemia, numbness/tingling, confusion, lethargy, N/V.

Metabolic Acidosis

HCO3 < 22, pH < 7.35. May be caused by increased bicarbonate loss or increased non-carbonic acids, diarrhea, shock, renal failure. Symptoms: headache, decreased BP, hyperkalemia, twitching, flushed, N/V, confusion, hyperventilating.

Metabolic Alkalosis

HCO3 > 26, pH > 7.45. May be caused by excessive metabolic acid loss such as vomiting, diuretic use, increased bicarbonate intake. Symptoms: restlessness followed by lethargy, tachycardia, hypoventilating, confusion, N/V, hypokalemia, tremors, cramps, tingling.

Uncompensation

Abnormal pH, and EITHER abnormal CO2 or HCO3.

Full Compensation

Normal pH, BOTH abnormal CO2 and HCO3.

Partial Compensation

Abnormal pH, BOTH abnormal CO2 and HCO3.