PP Exam #2: Acid & Base Balance

Normal pH

7.35-7.45

• <acidosis

• >alkalosis

Normal PaCO2

35-45

Normal Bicarbonate

22-26

Normal PaO2 (what is it?)

80-100+

• pressure

• unbound oxygen in bloodstream

Normal SaO2 (o2 sat) (what is it?)

>95%

• arterial

• oxygen bound to hemoglobin

PaO2 of 60 equals…

• SaO2 of 90%

  • poor perfusion to vital organs

Co2 acts as what in the blood?

ACID

Relationship between respirations and CO2

• increases respirations = ↓ CO2 in blood (blowing it off)

• decreased respirations = ↑ CO2 in blood (retaining it)

Renal system conserves _______ and excretes _______.

• conserves bicarbonate

• excretes acid

What happens in the kidneys when CO2 rises?

Kidneys retain bicarb (↑ bicarb) to compensate

Relationship between pH and paCO2 in respiratory?

INVERSE

• ↑ co2 = low pH (acidic)

• ↓ co2 = high pH (alkaline)

Relationship between pH and bicarbonate in metabolic?

DIRECT

• ↑ bicarb = high pH (alkaline)

• ↓ bicarb = low pH (acidic)

SEE WORKSHEET FOR PRACTICE PROBLEMS!!

SEE WORKSHEET FOR PRACTICE PROBLEMS!!

Respiratory Acidosis Symptoms

HYPERKALEMIA

• hypoventilation

• shallow breathing/ resp failure

• low pH

• high CO2

• dysrhythmias (peaked T)

• low BP

• weak muscles

  • compensation: kidneys conserve bicarb and secrete H+

Respiratory Alkalosis Symptoms

HYPOKALEMIA

• hyperventilation

• anxiety, pain

• mechanical ventilation

• high pH

• low CO2

• hypoxemia (low blood oxygen)

• numbness

• N/V

  • compensate: bicarb shift in kidneys

Metabolic Acidosis Symptoms

HYPERKALEMIA

• low pH

• low bicarb (high acid)

• diabetic ketoacidosis

• lactic acid accumulation/ shock

• severe diarrhea (losing bicarb)

• kidney disease (not making bicarb)

• low BP

• dysthymias (peaked T)

• cool, clammy, skin

  • compensate: lungs excrete CO2, Kussmaul respirations!!

Metabolic Alkalosis Symptoms

HYPOKALEMIA

• high pH

• high bicarb (low acid)

• prolonged vomiting & gastric suctioning (losing stomach acid)

• diuretics

• N/V

• dysthymias (u-wave)

  • compensate: decreased respiratory rate to retain CO2

What symptoms do all acidosis have in common?

• headache

• lethargic

• confusion

• dizzy

• low BP

• coma

What symptoms do all alkalosis have in common?

• headache

• lethargic

• confusion

• dizzy

• tachycardia