N715 Exam 3 New Pt 8 - acid-base
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Questions and Answers

What is a potential cause of hypovolemic hypernatremia?

  • Intravenous administration of isotonic saline
  • Loop diuretics leading to decreased sodium reabsorption (correct)
  • Increased osmotic pressure due to high urea levels
  • Excessive fluid intake

What is a characteristic of euvolemic hypernatremia?

  • It always leads to dehydration
  • It results from hypertonic saline administration
  • It often occurs in older individuals due to altered thirst mechanisms (correct)
  • Body sodium levels are normal despite fluid retention

Which factor does NOT directly contribute to hypervolemic hypernatremia?

  • Administering hypertonic saline
  • Excessive bicarbonate administration
  • Excessive sweating of hypotonic sweat (correct)
  • Fluid overload scenarios

Calculating free water deficit can be done using which formula?

<p>(0.6 x kg) x (Na/140-1) (A)</p> Signup and view all the answers

Which condition could lead to high sodium levels while maintaining normal fluid volume?

<p>Diabetes insipidus with increased urination (D)</p> Signup and view all the answers

What is the primary role of buffers in plasma?

<p>To prevent constant fluctuations in pH (C)</p> Signup and view all the answers

Which mechanism compensates for metabolic acidosis in the lungs?

<p>Increased respiratory rate (B)</p> Signup and view all the answers

What causes metabolic alkalosis?

<p>Too much bicarbonate or excessive loss of H+ (C)</p> Signup and view all the answers

What is the primary clinical concern when correcting sodium abnormalities too quickly?

<p>Cerebral edema (A)</p> Signup and view all the answers

In case of respiratory acidosis, which compensation mechanism takes longer to occur?

<p>Renal compensation (D)</p> Signup and view all the answers

Which condition is likely to lead to respiratory alkalosis?

<p>Hyperventilation (D)</p> Signup and view all the answers

What does an increase in bicarbonate concentration usually indicate?

<p>Excessive loss of metabolic acids (C)</p> Signup and view all the answers

Which of the following is a potential symptom of metabolic alkalosis?

<p>Muscle cramps (B)</p> Signup and view all the answers

What is a common cause of hypernatremia?

<p>Free water deficit (D)</p> Signup and view all the answers

What happens when sodium levels remain elevated for more than 48 hours?

<p>Body begins to adjust (D)</p> Signup and view all the answers

What is the primary role of physiological buffers in maintaining pH balance within the body?

<p>To bind excessive H+ or OH- without significant change in pH (A)</p> Signup and view all the answers

Which of the following best describes respiratory acidosis?

<p>Accumulation of carbonic acid due to hypoventilation (A)</p> Signup and view all the answers

Which condition is primarily associated with metabolic acidosis?

<p>Increased production of non-volatile acids like sulfuric acid (D)</p> Signup and view all the answers

In the context of acid-base imbalances, what occurs when the body retains organic acids?

<p>Decreased bicarbonate concentration in the blood (A)</p> Signup and view all the answers

What is the effect of sodium abnormalities on acid-base balance?

<p>Influences bicarbonate reabsorption and secretion processes (A)</p> Signup and view all the answers

Flashcards

Acid-Base Balance

The process of maintaining the correct pH (7.35-7.45) in the body, achieved mainly through the lungs and kidneys.

Carbonic Acid Equation

CO2 + H2O ⇌ H2CO3 ⇌ HCO3⁻ + H⁺. This system regulates pH by converting CO2 to bicarbonate and hydrogen ions.

Metabolic Acidosis/Alkalosis

Determined by the kidney's handling of bicarbonate (HCO3⁻). Imbalances result from problems with bicarbonate retention or excretion.

Volatile Acid

An acid that can be eliminated as a gas (e.g., CO2).

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Physiological Buffer

A system that binds excess H+ or OH⁻ ions without greatly changing pH. Found in both intracellular and extracellular fluids.

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Hypovolemic Hypernatremia

High sodium levels in the blood with low blood volume.

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Causes of Hypovolemic Hypernatremia

Loss of free water due to diuretics (loop/osmotic), DKA, or Diabetes Insipidus.

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Euvolemic Hypernatremia

High sodium levels with normal blood volume.

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Causes of Euvolemic Hypernatremia

Sweating, altered thirst mechanisms (aging or CNS problems), or insufficient water intake.

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Free Water Deficit

Calculating the amount of water needed to correct the electrolyte imbalance.

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Metabolic Acidosis

A condition where the body's pH is too low due to an imbalance in the kidneys' ability to regulate bicarbonate or eliminate hydrogen ions.

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Metabolic Alkalosis

A condition where the body's pH is too high due to excess bicarbonate or excessive loss of hydrogen ions.

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Respiratory Acidosis

A condition caused by inadequate breathing, leading to the buildup of carbon dioxide in the body, resulting in low pH.

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Respiratory Alkalosis

A condition characterized by excessive breathing, leading to reduced CO2 levels and an elevated pH.

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pH

A measure of acidity or alkalinity of a solution, important in maintaining homeostasis.

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Normal pH Range

The range of pH values considered healthy (7.35-7.45).

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Sodium Imbalances Risks

Rapid shifts in sodium levels can cause cerebral edema, or acute demyelination syndrome depending on the direction of the shift.

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Hypernatremia

A condition characterized by elevated sodium levels in the blood (above 145 mmol/L).

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Bicarbonate (HCO3-)

An important buffer in the body, playing a role in maintaining proper pH levels. Often represented as CO2.

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PCO2

Partial pressure of carbon dioxide in the blood, a key indicator of respiratory function in acid-base balance.

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Study Notes

Acid-Base Balance

  • pH is the negative logarithm of the hydrogen ion concentration.
  • A normal pH range is 7.35-7.45.
  • If hydrogen ion concentration is high, pH is low (acidic).
  • If hydrogen ion concentration is low, pH is high (alkaline).
  • Lungs and kidneys are major organs regulating acid-base balance.
  • CO2 + H2O → H2CO3 → HCO3- + H+ (Carbonic acid system/equation)
  • H+ must be neutralized or excreted.

pH Control Mechanisms

  • Kidneys: regulating bicarbonate (HCO3-).
  • Lungs: regulating CO2.
  • Chemical Buffers: usually plasma proteins and carbonic acid equation. Carbonic acid acts as a buffer. Red blood cells (RBCs) also bind H+ ions, acting as a buffer.
  • Volatile Acids (e.g., carbonic acid): eliminated as CO2 by the lungs.
  • Non-volatile Acids (e.g., sulfuric, phosphoric): eliminated by renal tubules.

Acid-Base Imbalances

  • Categories: Metabolic Acidosis (renal), Metabolic Alkalosis (excess bicarb or H+ loss), Respiratory Acidosis (decreased ventilation; CO2 retention), and Respiratory Alkalosis (increased ventilation; CO2 loss).
  • Causes: Different diseases and conditions lead to these imbalances.
  • Compensation: The body tries to compensate for imbalances through renal and respiratory mechanisms.

Anion Gap

  • Used to determine the cause of metabolic acidosis.
  • Equation: [Na+] - ([Cl-] + [HCO3-])
  • Normal range is ~8-12 mEq/L.
  • Mnemonic (MUDPILES): Methanol, Uremia, DKA/AKA (diabetic ketoacidosis), Paraldehyde/phenformin, Iron/INH, Lactic acidosis, Ethylene glycol, Salicylates

Mixed Acid-Base Disorders

  • Two or more primary acid-base disorders co-occurring.
  • Common in hospitalized patients.
  • Compensation degree is variable.

Response to Acid-Base Imbalance

  • The lungs and kidneys respond to imbalances in opposing ways to correct.
  • Interactions between the carbonic acid/bicarbonate buffer system and compensatory mechanisms regulate pH.

Electrolyte Imbalances

  • Anion Gap Metabolic Acidosis (MUDPILES): Mnemonic to remember causes.
  • Hypernatremia (Na+ >145): Free water deficit or excessive salt intake.
  • Hyponatremia (<135): Excess water intake and or loss of sodium. Treatment includes correcting volume and sodium.
  • Hyperkalemia (>5.0): Renal dysfunction, increased intake, or drug-induced.
  • Hypokalemia (<3.5): Low intake, excessive loss via urine or vomiting.

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Acid-Base Abnormalities PDF

Description

Explore the fundamental concepts of acid-base balance, including pH regulation and control mechanisms. Understand the roles of the lungs and kidneys in maintaining homeostasis, as well as the various acid-base imbalances. Test your knowledge on how these systems interact to regulate body functions.

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