Podcast
Questions and Answers
Which of the following is a physiological variable that can affect the therapeutic effect of medications?
Cultural beliefs have no impact on how patients respond to medications.
False
What is the primary route of medication administration for immediate effect?
Intravenous (IV)
Inhalation is a route of administration primarily used for _______.
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Match the following disorders with their probable compensation mechanism:
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What is the most logically organized system of medication measurement?
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Household measurement systems are the most accurate method for measuring medication.
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Name one potential for medication misuse within patient populations.
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What condition is characterized by a pH less than 7.35 and elevated PaCO2?
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Hyperventilation is associated with respiratory acidosis.
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What is the primary gas exchange abnormality associated with chronic renal disease?
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The body compensates for an acid-base disturbance by adjusting either __________ or __________ levels.
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Which of the following is NOT a cause of respiratory alkalosis?
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Fully compensated means the pH is in the normal range while both PaCO2 and HCO3 are out of range.
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In metabolic alkalosis, what is the expected trend for HCO3- levels?
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Match the acid-base disorder with its associated condition:
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Which of the following conditions is characterized by a low pH and a high PaCO₂?
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In fully compensated metabolic acidosis, both the pH and HCO₃⁻ are within normal ranges.
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What pH range indicates alkalosis?
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Metabolic _____ is characterized by a low pH and low HCO₃⁻.
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Match the condition to its compensation status:
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What condition is indicated by a normal pH with decreased HCO₃⁻?
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Partially compensated metabolic alkalosis is indicated by an excess of HCO₃⁻ and a decreased pH.
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What is the normal range for PaCO₂?
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Study Notes
Acid-Base Balance
-
Step 1:
- P: Primary variable (e.g., pH, PaCO2, HCO3)
- 2: Second variable
- 3: Third variable
-
Step 2:
- Identify the primary variable that is out of range:
- pH: Acidic if < 7.35, Alkaline if > 7.45
- PaCO2: Acidic if > 45, Alkaline if < 35
- HCO3: Acidic if < 22, Alkaline if > 26
- Identify the primary variable that is out of range:
-
Step 3:
-
Determine the type of imbalance, based on the primary variable:
- Metabolic acidosis: pH is low due to low HCO3
- Respiratory acidosis: pH is low due to high PaCO2
- Metabolic alkalosis: pH is high due to high HCO3
- Respiratory alkalosis: pH is high due to low PaCO2
-
Determine the type of imbalance, based on the primary variable:
Summary Table
-
Metabolic Acidosis:
- pH: Decreased
- PaCO2: Normal
- HCO3: Decreased
-
Respiratory Acidosis:
- pH: Decreased
- PaCO2: Increased
- HCO3: Normal
-
Metabolic Alkalosis:
- pH: Increased
- PaCO2: Increased
- HCO3: Increased
-
Respiratory Alkalosis:
- pH: Increased
- PaCO2: Decreased
- HCO3: Decreased
Compensation
-
Uncompensated
- Body is NOT trying to correct the acid-base imbalance
- pH will be outside of the reference range
-
Partially Compensated
- Body is trying to correct the acid-base imbalance
- pH is still outside of the reference range, but the compensatory mechanism is attempting to bring it back into range
- One or more of the other variables will be out of range
-
Fully Compensated
- Body has successfully corrected the acid-base imbalance
- pH is within the reference range
- All other parameters are outside of their reference ranges
Causes of Acid-Base Imbalances
-
Respiratory Acidosis:
-
Causes:
- Hypoventilation
- Impaired gas exchange
-
Examples:
- Pulmonary conditions (e.g., COPD, pneumonia, asthma)
- Medications (e.g., CNS depressants)
- Respiratory conditions (e.g., sleep apnea)
-
Causes:
-
Respiratory Alkalosis
-
Cause:
- Hyperventilation
-
Examples:
- Anxiety
- Stress
- Pain
- Fear
- Pulmonary edema
-
Cause:
-
Metabolic Acidosis:
-
Causes:
- Decreased HCO3 (bicarbonate) level
-
Examples:
- Chronic renal disease
- Uncontrolled diabetes mellitus
- Sepsis
- Starvation
- Prolonged diarrhea
-
Causes:
-
Metabolic Alkalosis:
-
Causes:
- Increased HCO3 level
-
Examples:
- Prolonged vomiting
- Prolonged gastric suctioning
- Excessive antacids
- Cushing syndrome
-
Causes:
Other Considerations
-
Genetic Factors:
- Individual genetic makeup can impact medication metabolism and therapeutic effects.
Routes of Administration
-
Oral:
- Sublingual
- Buccal
-
Parenteral:
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SQ)
- Intradermal (ID)
- Other: epidural, intrathecal, intraosseous, intraperitoneal, intrapleural, intra-arterial
-
Topical:
- Direct application
- Body cavity
- Inhalation
- Intraocular
Measurement Systems
-
Metric System:
- Most logically organized
- Meter, liter, gram
-
Household System:
- Most familiar to individuals
- Disadvantage: inaccuracy
-
Solutions:
- Solids dissolved in fluid
- Concentration expressed as:
- Units of mass per unit volume (g/L, mg/mL)
- Percentage (10% solution)
- Proportions (1/1000)
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Description
Test your knowledge on acid-base balance concepts, including the identification of primary variables and types of imbalances. This quiz will cover essential definitions and summaries related to metabolic and respiratory acidosis and alkalosis. Perfect for nursing students and healthcare professionals.
