Acid-Base Imbalances and Disorders
46 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following best describes the primary role of the pulmonary and renal systems in maintaining pH balance?

  • They compensate for each other to help maintain pH. (correct)
  • They work together to create acid imbalances.
  • They act independently to regulate acid levels.
  • They do not play a role in pH balance.

    • An increase in blood pH level will cause the kidneys to increase H+ elimination.

    True (A)

    What is the gold standard diagnostic test for checking acid/base balance?

    arterial blood gases (ABGs)

    The Allen test is performed before an arterial blood draw to ensure adequate _______ to the hand.

    <p>perfusion</p> Signup and view all the answers

    A PaCO2 reading of 50 mmHg indicates:

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

    Venous blood gas values are the same as arterial blood gas values.

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

    What is the normal ratio of bicarbonate to carbonic acid in the body?

    <p>20:1</p> Signup and view all the answers

    Match the following terms with their corresponding definitions:

    <p>Hypercapnia = Elevated CO2 levels in the blood Hypocapnia = Low CO2 levels in the blood PaCO2 = Partial pressure of carbon dioxide in arterial blood ABGs = Arterial blood gases</p> Signup and view all the answers

    What is a potential risk for a patient with COPD who receives high amounts of supplemental oxygen?

    <p>Carbon dioxide narcosis (A)</p> Signup and view all the answers

    Patients with fractured ribs are at a decreased risk for inadequate ventilation.

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

    What pharmacological agent is used to reverse the effects of opioid overdose?

    <p>Naloxone</p> Signup and view all the answers

    In COPD, _________ breathing can help open the airways during exhalation.

    <p>pursed-lip</p> Signup and view all the answers

    Which of the following is a common clinical manifestation of chronic respiratory acidosis?

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

    An expected outcome of effective nursing care for respiratory acidosis is a decreased breathing pattern.

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

    Match the following causes with the associated conditions or treatments:

    <p>Pneumonia = Antibiotics Opioid overdose = Naloxone COPD = Bronchodilators Respiratory Acidosis = Reposition Patient</p> Signup and view all the answers

    What is a key nursing intervention used to improve breathing in a patient with respiratory acidosis?

    <p>Repositioning the patient (B)</p> Signup and view all the answers

    What is the normal range for anion gap?

    <p>8 - 16 (A)</p> Signup and view all the answers

    A patient at high elevation is at risk for respiratory alkalosis due to increased oxygen levels.

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

    What is the primary medication used to treat acidosis?

    <p>sodium bicarbonate</p> Signup and view all the answers

    When the body tries to correct a pH imbalance by adjusting CO2 or HCO3, it is known as ______.

    <p>compensation</p> Signup and view all the answers

    Match the following acid-base imbalances with their characteristics:

    <p>Respiratory Acidosis = Increased PaCO2, decreased pH Respiratory Alkalosis = Decreased PaCO2, increased pH Metabolic Acidosis = Decreased HCO3, decreased pH Metabolic Alkalosis = Increased HCO3, increased pH</p> Signup and view all the answers

    What is a typical sign of respiratory acidosis?

    <p>Increased carbon dioxide levels (D)</p> Signup and view all the answers

    An individual who has metabolic alkalosis will have a high pH and a high bicarbonate level.

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

    What is the primary organ involved in metabolic acid-base regulation?

    <p>kidneys</p> Signup and view all the answers

    A patient experiencing hyperventilation may be at risk for respiratory ______.

    <p>alkalosis</p> Signup and view all the answers

    Which electrolyte imbalance is directly associated with metabolic alkalosis?

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

    The ROME rule states that in metabolic imbalances, pH and HCO3 move in opposite directions.

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

    What is a common cause of metabolic alkalosis related to gastric secretions?

    <p>vomiting</p> Signup and view all the answers

    In a partially compensated acid-base imbalance, the pH is ______.

    <p>abnormal</p> Signup and view all the answers

    Match the following acid-base disorders with their typical compensation mechanism:

    <p>Metabolic Acidosis = Increased respiratory rate Metabolic Alkalosis = Decreased respiratory rate Respiratory Acidosis = Increased bicarbonate retention by kidneys Respiratory Alkalosis = Increased bicarbonate excretion by kidneys</p> Signup and view all the answers

    What does a low PaO2 indicate in an arterial blood gas (ABG)?

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

    Which of the following is a common sign of hypocalcemia?

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

    Metabolic alkalosis is a common primary disorder.

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

    What electrolyte imbalance is commonly associated with the daily use of loop diuretics like lasix/furosemide?

    <p>hypokalemia</p> Signup and view all the answers

    In metabolic alkalosis, the kidneys excrete more _____ ions.

    <p>H+</p> Signup and view all the answers

    Match the following causes with the type of condition they are most likely to cause:

    <p>Excessive use of antacids = Metabolic Alkalosis Sudden failure of ventilation = Acute Respiratory Acidosis COPD = Chronic Respiratory Acidosis Prolonged vomiting in infants = Metabolic Alkalosis</p> Signup and view all the answers

    Which of the following is a risk factor for metabolic alkalosis?

    <p>Treatment for metabolic acidosis (A)</p> Signup and view all the answers

    In metabolic alkalosis, the respiratory rate typically increases to remove excess carbon dioxide.

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

    What is the main treatment for restoring pH in a patient with metabolic alkalosis?

    <p>fluids</p> Signup and view all the answers

    In acute respiratory acidosis, the PaCO2 rises ________.

    <p>rapidly</p> Signup and view all the answers

    Which of the following symptoms is associated with acute respiratory acidosis?

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

    In chronic respiratory acidosis, the kidneys retain hydrogen ions to compensate.

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

    What is the primary stimulus for respirations in patients with chronically elevated PaCO2 levels?

    <p>PaO2</p> Signup and view all the answers

    In chronic respiratory acidosis, the respiratory center becomes less sensitive to _______ as a stimulant of respiratory drive.

    <p>CO2</p> Signup and view all the answers

    Which of the following is a possible cause of acute respiratory acidosis?

    <p>Overdose of a respiratory depressant (D)</p> Signup and view all the answers

    Match the following treatments with the conditions they are most applicable for:

    <p>Administer KCL and NaCl solutions = Metabolic Alkalosis Oxygen = Chronic Respiratory Acidosis Monitor for impaired gas exchange = Both Metabolic Alkalosis and Respiratory Acidosis Elevate head of bed = Both Metabolic Alkalosis and Respiratory Acidosis</p> Signup and view all the answers

    Flashcards

    Compensation (in A/B balance)

    The body's natural response to correct an imbalance, often involving multiple organ systems working together.

    Pulmonary and Renal Compensation

    When the respiratory system and the kidneys work together to maintain a stable pH balance.

    Kidneys: The Metabolic Compensator

    The organ system that primarily compensates for metabolic acid-base imbalances.

    pH's Impact on HCO3 and H+

    The change in pH impacts how the body manages bicarbonate (HCO3-) and hydrogen ions (H+).

    Signup and view all the flashcards

    Respiratory Compensation: Breathing Changes

    A rapid change in pH triggers the respiratory system to adjust breathing rate and depth.

    Signup and view all the flashcards

    Respiratory Compensation Goal

    The goal of respiratory compensation is to restore the optimal ratio of bicarbonate to carbonic acid (20:1).

    Signup and view all the flashcards

    Arterial Blood Gases (ABGs)

    The gold standard for assessing acid-base balance in the body.

    Signup and view all the flashcards

    Allen Test

    A test used to assess blood flow in the radial artery before an ABG draw.

    Signup and view all the flashcards

    Carbon Dioxide Narcosis in COPD

    Suppression of the respiratory center by high oxygen levels in individuals with chronic obstructive pulmonary disease (COPD) can lead to a buildup of carbon dioxide in the blood, resulting in a condition known as carbon dioxide narcosis.

    Signup and view all the flashcards

    Lung Conditions Affecting Ventilation

    A condition that alters the structure of the lungs, leading to ineffective ventilation. Symptoms might include daytime sleepiness or acute manifestations like flushed skin and irritability.

    Signup and view all the flashcards

    Bronchodilators

    A group of medications that work by widening the airways, primarily used for conditions like COPD to improve airflow.

    Signup and view all the flashcards

    Gas Exchange

    The process of taking in oxygen and expelling carbon dioxide, a vital function for maintaining life. Respiratory acidosis occurs when the body is not able to efficiently remove carbon dioxide from the blood, leading to a buildup of acid.

    Signup and view all the flashcards

    Pursed-Lip Breathing

    A method of breathing that involves a slow, deep inhalation followed by a prolonged, forceful exhalation through pursed lips. Often used for patients with COPD to help open airways and control breathing.

    Signup and view all the flashcards

    Incentive Spirometer

    A device that prompts patients to take deep breaths, encouraging lung expansion and improving overall lung function. Often used after surgery or for individuals with lung conditions.

    Signup and view all the flashcards

    Pulmonary Vest

    A type of chest physiotherapy that utilizes a weighted vest to loosen and mobilize secretions in the airways, making it easier to cough them up.

    Signup and view all the flashcards

    Level of Consciousness (LOC)

    An important nursing assessment that involves observing the patient's mental state, including their level of consciousness, alertness, and orientation. This helps determine the impact of respiratory acidosis on brain function.

    Signup and view all the flashcards

    What is the anion gap?

    The difference between the concentrations of positively charged electrolytes (sodium and potassium) and negatively charged electrolytes (chloride and bicarbonate).

    Signup and view all the flashcards

    What is metabolic acidosis?

    A condition characterized by a low blood pH (below 7.35) primarily resulting from a buildup of acids or loss of bicarbonate.

    Signup and view all the flashcards

    What is metabolic alkalosis?

    A condition characterized by a high blood pH (above 7.45) due to a loss of acids or an excess of bicarbonate.

    Signup and view all the flashcards

    What is respiratory acidosis?

    A condition characterized by a low blood pH (below 7.35) due to an excess of carbon dioxide in the blood.

    Signup and view all the flashcards

    What is respiratory alkalosis?

    A condition characterized by a high blood pH (above 7.45) due to a low level of carbon dioxide in the blood.

    Signup and view all the flashcards

    What does it mean when an acid-base imbalance is 'compensated'?

    Indicates the body is compensating for an acid-base imbalance. It signifies the kidneys or lungs are working to bring the pH back to normal.

    Signup and view all the flashcards

    What does it mean when an acid-base imbalance is 'uncompensated'?

    Indicates the body is not effectively compensating for an acid-base imbalance. The pH may be abnormal.

    Signup and view all the flashcards

    What is metabolic acidosis?

    A condition characterized by a low blood pH (below 7.35) and low bicarbonate levels, typically caused by increased acid production or loss of bicarbonate.

    Signup and view all the flashcards

    What is metabolic alkalosis?

    A condition characterized by a high blood pH (above 7.45) and high bicarbonate levels, typically caused by loss of acid or excess bicarbonate intake.

    Signup and view all the flashcards

    What is respiratory acidosis?

    A condition characterized by a low blood pH (below 7.35) and high carbon dioxide levels, typically caused by impaired lung function or inadequate ventilation.

    Signup and view all the flashcards

    What is respiratory alkalosis?

    A condition characterized by a high blood pH (above 7.45) and low carbon dioxide levels, typically caused by hyperventilation or excessive breathing.

    Signup and view all the flashcards

    What is hypoxia?

    A condition that occurs when the body's cells do not receive enough oxygen. This can be caused by a variety of factors, including respiratory problems, heart problems, and anemia.

    Signup and view all the flashcards

    What is hyperkalemia?

    A condition characterized by a high concentration of potassium in the blood. It can be dangerous, as it can disrupt the electrical activity of the heart.

    Signup and view all the flashcards

    What is hypokalemia?

    A condition characterized by a low concentration of potassium in the blood. It can lead to muscle weakness, fatigue, and irregular heartbeat.

    Signup and view all the flashcards

    Metabolic Alkalosis

    A condition where the blood is too alkaline due to a loss of hydrogen ions (H+).

    Signup and view all the flashcards

    Respiratory Acidosis

    A condition where the body retains too much carbon dioxide, leading to a buildup of acid in the blood.

    Signup and view all the flashcards

    Hypocalcemia

    Symptoms such as muscle twitches, spasms, numbness, and tingling in fingers and mouth are common in patients with.

    Signup and view all the flashcards

    Respiratory Acidosis: What causes a drop in pH?

    A decrease in pH due to an increase in carbon dioxide (CO2) levels.

    Signup and view all the flashcards

    Metabolic Alkalosis: What causes an increase in pH?

    A condition where the body loses too much acid, leading to a buildup of base in the blood.

    Signup and view all the flashcards

    What are some symptoms of Respiratory Acidosis?

    Signs such as confusion, fatigue, and headache characterize.

    Signup and view all the flashcards

    What are some common causes of Metabolic Alkalosis?

    Conditions such as prolonged vomiting, NG tube suctioning, and diuretic use can contribute to.

    Signup and view all the flashcards

    How does the body try to compensate for Respiratory Acidosis?

    The kidneys attempt to compensate by retaining bicarbonate (HCO3-), which acts as a base.

    Signup and view all the flashcards

    How does the body try to compensate for Metabolic Alkalosis?

    The kidneys compensate by excreting more hydrogen ions (H+) in the urine.

    Signup and view all the flashcards

    What is the mechanism of action of KCl and NaCl in treating metabolic alkalosis?

    The kidneys try to restore H+ ions by conserving them and excreting bicarbonate (HCO3-) in the urine.

    Signup and view all the flashcards

    How does the body's respiratory system try to compensate for Metabolic Alkalosis?

    When the body is in a state of metabolic alkalosis, it will try to retain carbon dioxide, leading to a slower respiratory rate.

    Signup and view all the flashcards

    How does the body compensate for metabolic alkalosis?

    The respiratory rate slows down in an attempt to retain CO2 and increase the blood's acidity.

    Signup and view all the flashcards

    What are some potential risks of taking too many antacids?

    Excessive use of bicarbonate antacids, such as Tums, can contribute to.

    Signup and view all the flashcards

    What are some nursing interventions for managing patients with metabolic alkalosis?

    They monitor for signs of fluid volume deficit, such as hypotension and tachycardia.

    Signup and view all the flashcards

    What are some common causes of acute respiratory acidosis?

    Overdosing on narcotics can lead to respiratory depression, which is a common cause of.

    Signup and view all the flashcards

    Study Notes

    Acid-Base Imbalances

    • Compensation: The body's natural response to correct pH imbalances. Usually, the system not causing the problem tries to compensate. Pulmonary and renal systems compensate for each other. Metabolic compensation occurs via the kidneys. Respiratory compensation involves adjusting the rate and depth of respirations to affect CO2 elimination, which restores the bicarbonate-to-carbonic acid ratio (20:1).

    Respiratory Acid-Base Disorders

    • Metabolic Compensation: The kidneys compensate for metabolic acid-base imbalances by altering bicarbonate conservation and H+ elimination.
    • Respiratory Compensation: Changes in pH trigger respiratory compensation, impacting the rate and depth of respirations and thus, CO2 elimination, to restore the bicarbonate-carbonic acid ratio.

    Diagnostic Tests

    • Arterial Blood Gases (ABGs): The gold standard for assessing acid-base balance, reflecting the balance throughout the body better than venous or capillary blood. Obtained via the radial artery.
    • Allen Test: Performed prior to an arterial blood draw to ensure adequate hand perfusion.
    • Venous Blood Gases: Can be used for baseline values, but note that values differ from arterial blood gases. Compare to pulse oximetry readings; a 90% oxygen saturation correlates to a PaO2 of approximately 60 mmHg.

    Arterial Blood Gases (ABGs)

    • Components: pH, PaCO2 (partial pressure of carbon dioxide in arterial blood), and HCO3 (bicarbonate).
    • PaCO2: Measures dissolved CO2 in arterial blood, reflecting the respiratory component of acid-base balance. Normal range: 35-45 mmHg.
      • Hypercapnia: Elevated CO2 levels (>45 mmHg). Associated with conditions like Chronic Obstructive Pulmonary Disease (COPD).
      • Hypocapnia: Low CO2 levels (<35 mmHg). Requires immediate attention.
    • HCO3: Reflects metabolic component. Normal range: 22-26 mEq/L.
    • Anion Gap: The difference between sodium, potassium, chloride, and bicarbonate. (Normal range: 8-16 mEq/L). Used to evaluate metabolic acidosis.

    Risk Factors for pH Imbalances

    • Exercise/Altitude: High altitudes reduce atmospheric oxygen, leading to increased CO2 and respiratory acidosis.
    • Critically Ill Patients: Are at risk of acid-base imbalances.
    • Conditions: COPD, diabetes, asthma, kidney conditions can result in pH imbalances.

    Lifespan and Cultural Considerations

    • Nutrition, Medications, and Treatment Adherence: Crucial for maintaining fluid balance and managing chronic conditions (diabetes, COPD, kidney disease). Six to eight cups of fluid daily are recommended.

    Nursing Process: Assessment & Independent Interventions

    • History: Collecting patient history pertinent to acid-base imbalances.
    • Daily Monitoring: Weight, intake and output (I&O), urine characteristics (amount, color, odor), respiratory and renal function (rate/depth of respiration, BUN, Creatinine, GFR), oxygen saturation, vital signs, level of consciousness (LOC), and skin color.

    Pharmacologic Therapy

    • Acidosis: Sodium bicarbonate is the primary treatment, acting as a base to neutralize acids. Careful monitoring for signs of alkalosis is essential.

    Interrelated Concepts

    • Cognition: Low oxygenation can cause confusion and decreased mental status.
    • Fluid Electrolyte Balance: Imbalances can affect perfusion, potentially causing dysrhythmias.
    • Oxygenation: Hyperventilation and hypoventilation affect acid-base balance.
    • Stress and Coping: Anxiety can lead to hyperventilation, causing acid-base imbalances.

    Interpreting ABGs

    • Steps:
      1. Assess pH.
      2. Analyze PaCO2.
      3. Examine pH-PaCO2 relationships.
      4. Evaluate bicarbonate (HCO3).
      5. Determine respiratory or metabolic origin.
      6. Look for compensation.
      7. Evaluate oxygenation (PaO2).

    Acid-Base Values (Normal Ranges)

    Condition Value
    pH 7.35-7.45
    PaCO2 (resp) 35-45 mmHg
    HCO3 (metabolic) 22-26 mEq/L

    Classification of Acid-Base Imbalances

    • Compensated: pH is normal, even if CO2 or HCO3 levels are abnormal.
    • Uncompensated: Either CO2 or HCO3 is abnormal but pH is abnormal.
    • Partially Compensated: Both CO2 and HCO3 levels are abnormal, and pH is abnormal but not as extreme as in uncompensated cases.

    ROME: Respiratory Opposite, Metabolic Equal

    • Respiratory acidosis (resp. ↑ CO2) = metabolic (↓ HCO3) compensation.
    • Respiratory alkalosis (res ↓ CO2) = metabolic (↑ HCO3) compensation

    Metabolic Acidosis

    • Results from a decrease in pH and HCO3 levels.
    • Can be caused by loss of acid or excess bicarbonate.
    • Respiratory compensation involves lower respirations (to increase CO2)

    Metabolic Alkalosis

    • Caused by excess bicarbonate or loss of acid.
    • Characterized by a high pH and HCO3 levels.
    • Respiratory compensation involves increased respirations (to decrease CO2)

    Risk Factors for Metabolic Alkalosis

    • Frequent/prolonged vomiting.
    • NG tube suctioning.
    • Excessive use of diuretics (like Lasix).
    • Excess bicarbonate intake (antacids, baking soda).
    • Hospitalization.
    • Hypokalemia.

    Diagnostic Tests

    • ABGs: Assess pH imbalances.
    • Electrolyte Levels (K, Ca): Potential indicators of hypokalemia, or hypocalcemia
    • Urine pH: Low urine pH indicates excretion of H+ ions.
    • ECG: Assess for arrhythmias (especially if hypokalemic).

    Pharmacological Therapy for Metabolic Alkalosis

    • Fluid Resuscitation: Restores normal fluid volumes.
    • Potassium Chloride (KCl): Replaces lost potassium and helps kidneys restore H+ ions.
    • Sodium Chloride (NaCl) Solutions: Promotes renal bicarbonate excretion.

    Lifespan Considerations: Metabolic Alkalosis

    • Infants and Children: More susceptible to alkalosis due to vomiting, NG suctioning, or diuretic use.
    • Older adults: Increased risk due to decreased thirst mechanisms leading to dehydration.

    Nursing Process: Metabolic Alkalosis

    • Risk Identification: Patients using antacids excessively, or receiving improper sodium bicarbonate administration.
    • Assessment: Observations, interviews, signs, and symptoms (e.g. numbness, tingling, muscle spasms). Vital signs, breathing patterns, tendon reflexes, and neurologic function are to be carefully evaluated.
    • Analysis & Problem Identification: Impaired oxygenation (hypoxic), Electrolyte imbalances and potential for cardiovascular dysfunction.
    • Planning & Goals: Focus on restoring normal pH, resolving hypokalemia and hypoxia concerns, educating on the importance of proper medication use.
    • Implementation: Monitor for impairments in gas exchange, monitor fluid volume (I&O, daily weights), treat/manage hypoxia, and monitor electrolytes.
    • Evaluation: Assess for improvement in acid-base status, resolve hypokalemia/hypoxia symptoms, and that education is effective in preventing recurrence.

    Respiratory Acidosis

    • Characterized by a lowered pH and an elevated PaCO2.
    • Acute: Sudden onset of hypoventilation: lung issues, overdose.
    • Chronic: Associated with COPD, asthma. Significant compensation by bicarbonate retention.

    Respiratory Alkalosis

    • Characterized by a higher pH and a decreased PaCO2, associated with conditions such as hyperventilation due to anxiety, respiratory distress, or fever.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    This quiz covers the fundamental concepts of acid-base imbalances, including compensation mechanisms by the pulmonary and renal systems. It also delves into respiratory acid-base disorders and the role of diagnostic tests like arterial blood gases in assessing acid-base balance.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser