3221: LECTURE 1 PART 3

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Last updated 8:21 PM on 8/22/26
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51 Terms

1
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Normal arterial pH?

7.35–7.45 (Midpoint = 7.4)



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What is acidosis?

pH < 7.35

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What is alkalosis?

pH > 7.45

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What 2 systems control acid-base balance?

Lungs + kidneys

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Lungs regulate?

PaCO₂

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Kidneys regulate?

HCO₃⁻


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Normal PaCO2 levels?

35–45 mmHg

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Normal steady-state PaCO₂?

~40 mmHg

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Normal HCO3?

22–26 mEq/L

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Normal PaO2?

80–100 mmHg

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Normal SaO2?

95–100%

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Hypercapnia?

Too much CO₂/CO₂ retention

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Most common reason for hypercapnia in this lecture?

Hypoventilation

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Hypocapnia?

Too little CO₂/too much CO₂ blown off

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Primary respiratory problem starts with a change in?

PaCO₂


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Who compensates for a respiratory problem?

Kidneys/metabolic system

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Primary metabolic problem starts with a change in?

HCO₃⁻


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Who compensates for a metabolic problem?

Lungs/respiratory system

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Does compensation make pH completely normal?

NO


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Compensation moves pH where?

TOWARD normal


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Metabolic acidosis ABG pattern?

↓ pH + ↓ HCO₃⁻ + ↓ PaCO₂

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Main value causing metabolic acidosis?

Low HCO₃⁻


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↓ pH + ↓ HCO₃⁻ = ?

Metabolic acidosis

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Metabolic alkalosis ABG pattern?

↑ pH + ↑ HCO₃⁻ + ↑ PaCO₂

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↑ pH + ↑ HCO₃⁻ = ?

Metabolic alkalosis

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Respiratory acidosis pattern?

↓ pH, ↑ CO2

27
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pH ↓ + CO₂ ↑ = ?

Respiratory acidosis

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Respiratory alkalosis pattern?

↑ pH , ↓ PaCO₂ , HCO₃⁻

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↑ pH + ↓ PaCO₂ = ?

Respiratory alkalosis

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ABG QUICK RULES

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First thing to look at on an ABG?

pH


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pH <7.35?

Acidosis


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pH >7.45?

Alkalosis

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Metabolic: pH + HCO₃⁻ move how?

SAME direction

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Respiratory: pH + CO₂ move how?

OPPOSITE directions


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ROME?

Respiratory Opposite
Metabolic Equal


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Low pH + low HCO₃⁻?

Metabolic acidosis

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High pH + high HCO₃⁻?

Metabolic alkalosis

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Low pH + high CO₂?

Respiratory acidosis

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High pH + low CO₂?

Respiratory alkalosis

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ABG: pH 7.28. Acid or alkaline?

Acid


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ABG: pH 7.28 + HCO₃⁻ 16.6. Disorder?

Metabolic acidosis


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Why is HCO₃⁻ important here?

It is LOW and follows the low pH

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Why would CO₂ decrease with metabolic acidosis?

Respiratory compensation → lungs blow off CO₂

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CASE STUDY

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23-year-old with Type 1 DM + postural hypotension + tachycardia. Think?

Volume depletion

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Type 1 DM + Kussmaul respirations + acetone breath. Important acid-base clue?

Metabolic acidosis pattern

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What are Kussmaul respirations?

Important respiratory finding in this metabolic acidosis case

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What unusual breath finding does the patient have?

Acetone-smelling breath

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Chest x-ray finding?

Right lower lobe consolidation

51
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Why is confusion important?

Neurologic changes can occur with sodium/water imbalance