Acid/Base

for cells to function optimally

metabolic processes must maintain a steady balence between the acids and the bases found in the body

circulatory

• first line of defence

• chemical and protein buffer (mediators)

• mediators bind/release H+ ions as needed neutralizing acids/bases

• responds quickly to minor changes in pH

respiratory

• second line of defence

• increases and decreases breathing rate to increase or decrease acid/base

• co2 = H+ = Acid

  • breathing faster = removing more co2 = making the body more basic

  • slower breathing = holding in co2 = making body more acidic

renal/metabolic

• 3rd line of defence

• much slower response time

• control the movement of hco3 in the urine

  • pee out more h+ and hold onto more hco3 = base increases

  • pee out more hco3 and hold onto h+ = acid increases

these 3 systems can only work to fix acid and base if they are…

HEALTHY SYSTEMS

• cant fix anything if its the issue

levels of hypoxia

• 80-100: normal oxygenation

• 60-79: mild hypoxemia

  • putting person on nasal canula

• 40-59: moderate hypoxemia

  • need an increased flow of o2 source

    • adding concentration to o2 using a mask and more air flow

• <40: severe hypoxemia

  • ventilator support

  • very critical (ICU)

respiratory causes (acidosis)

• slower breathing (hypoventilation) - why

  • something obstructing airway

  • illness (ex:COPD)

• chest trauma

  • cant breath in and out so your holding in more co2

• pulmonary edema

  • swelling in lungs

  • alveoli level is full of fluid so it cant make good gas exchange meaning o2 is not sent out

• drug overdose

  • narcotics (ex: opiates)

    • side effects: respiratory depression (hypoventilation)

  • benzodiazipines

    • ex: antianxiety meds

      • 
        

metabolic (kidney) causes (acidosis)

• renal failure

  • kidneys typically get rid of excess H+ ions and hold onto bicarb but if the kidneys arent working they arent going to be able to do this

• diarrhea

  • poop out the bicarb (puke out the acid)

  • makes u poop out too much bicarb

• shock

  • hypovolemia

    • decreased volume and our body cant compensate

  • dont have good volume/perfusion

  • not good gas exchange happening meaning nothing is being sent out

• Saliculate OD (asprin OD)

• DKA (diabetic ketoacidosis)

  • dont have glucose to breakdown so were breaking down other body tissues like fat

    • breaks down fat = increased acid

• hyperkalemic = acidosis

respiratory acidosis (how body will compenste)

• respiratory is causing the problem

  • too much co2

  • kidneys are the only line of defence

• kidneys will pee out more h+ and reabsorb hco3 back into circulation

metabolic acidosis (how the body will compensate)

• kidneys cause the problem

• respiratory is 1st line of defence: rapid, deep respirations (remove as much co2)

• kidneys if working somewhat normal will try to pee out more h+ and hold onto more hco3

respiratory causes (alkalosis)

• hyperventilation (most common)

  • anxiety

• increased altitudes

  • your not used to the increased or decreased amount of o2 so we tend to breath faster

• pregnancy

• increased fever

• hypoxia: decreased o2 = tissues not recieving enough o2 to work properly

• initial stages of pulmonary embolism

metabolic causes (alkalosis)

• loss of gastric juices

  • throwing up

  • suctioning too much gastic juices out

• k+ wasting diuretics

  • hypokalemia = alkalosis

  • h+ moves into the cell and not into the blood causing the blood to be more alkolotic

• overuse of antiacids

respiratory alkalosis (how the body trys to compensate)

• lungs not working

• kidneys will try to pee less h+ and reabsorb less hco3

metabolic alkalosis (how the body trys to compensate)

• 1st: lungs will try to increase co2 by shallow slow respirations

• 2nd kidneys: attempt (if working) to pee less h+ and absorb less hco3

uncompensated

• pH will be abnormal

• either hco3 or co2 will be abnormal (ONLY ONE)

  • thats ur culprit

• either hco3 or co2 will be normal (ONLY ONE)

  • shows that no compensation is happening

partially compensated

• pH will be abnormal (will be alk or acid)

• both co2 and hco3 will be abnormal

  • the one that matches up to pH (if alk or acid) that will be ur culprit

fully compensated

• pH is NORNAL

  • 7.4 is perfect (wont know if respiratory or metabolic)

  • 7.35<7.4 (acidosis) but normal

  • 7.4<7.45 (alkalosis) but normal

• co2 and hco3 will be abnormal

  • whichever matches up with pH will be ur culprit