Acid-Base Imbalances Quiz
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Questions and Answers

What is the primary result of an acid-base imbalance?

  • Change in the ratio of acid to base content (correct)
  • Decreased oxygen levels in blood
  • Increase in blood glucose levels
  • Increased heart rate

    • Which of the following is a characteristic of metabolic acidosis?

  • Bicarbonate concentration is less than 22 mEq/L (correct)
  • pH rises above 7.45
  • Increase in carbonic acid
  • Respiratory rate decreases

    • What indicates respiratory acidosis?

  • pH around 7.40 and normal bicarbonate levels
  • pH below 7.45 with normal carbon dioxide levels
  • pH above 7.45 and carbon dioxide below 35 mmHg
  • pH below 7.35 and carbon dioxide above 45 mmHg (correct)

    • How does metabolic alkalosis generally manifest in the body?

    <p>Increased bicarbonate concentration above 26 mEq/L</p> Signup and view all the answers

    What is a common cause of metabolic acidosis?

    <p>Diabetic ketoacidosis</p> Signup and view all the answers

    What pH level categorizes respiratory alkalosis?

    <p>Above 7.45</p> Signup and view all the answers

    Which condition can result in an increase of carbonic acid in the body?

    <p>Acute hypoventilation</p> Signup and view all the answers

    Which of the following is NOT a classification of acid-base imbalances?

    <p>Neurogenic imbalances</p> Signup and view all the answers

    What is Mr. James's most immediate nursing priority upon arrival in the emergency department, considering his presenting symptoms?

    <p>Assess airway, breathing, and circulation</p> Signup and view all the answers

    Which symptom most likely indicates Mr. James is experiencing a state of shock?

    <p>Cool and clammy skin</p> Signup and view all the answers

    Why might Mr. James be exhibiting confusion and disorientation after the fall?

    <p>Severe blood loss and hypovolemia</p> Signup and view all the answers

    What vital sign indicates potential hypovolemic shock in Mr. James?

    <p>Blood pressure of 100/60 mmHg</p> Signup and view all the answers

    What diagnostic test is most likely to be ordered for Mr. James to assess his blood loss?

    <p>Complete blood count (CBC)</p> Signup and view all the answers

    When assessing Mr. James in the emergency department, which finding would be a focus of concern beyond the initial assessment?

    <p>Urinary output via catheter at 20 mL in an hour</p> Signup and view all the answers

    In the context of Mr. James's treatment, what is the purpose of administering normal saline via large-bore IVs?

    <p>To restore blood volume and improve circulation</p> Signup and view all the answers

    Which characteristic of Mr. James's vital signs suggests he is in a state of tachycardia?

    <p>Heart rate of 130 bpm</p> Signup and view all the answers

    What is a by-product produced from the metabolism of fats that leads to metabolic acidosis?

    <p>Ketone bodies</p> Signup and view all the answers

    Which condition can result from starvation and lead to metabolic acidosis?

    <p>Acute alcoholism</p> Signup and view all the answers

    Which scenario is associated with systemic lactic acidosis?

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

    What is a common consequence of excessive exercise in relation to metabolic acidosis?

    <p>Inadequate buffering of muscle acidity</p> Signup and view all the answers

    Which condition can cause metabolic acidosis due to an overdose of a specific drug?

    <p>Salicylate toxicity</p> Signup and view all the answers

    What is the effect of diuretic drugs like spironolactone on metabolic acidosis?

    <p>Conserve hydrogen ions</p> Signup and view all the answers

    Which factor can decrease bicarbonate levels leading to metabolic acidosis?

    <p>Severe diarrhea</p> Signup and view all the answers

    What causes an increase in chloride ions that results in metabolic acidosis?

    <p>Use of bile acid sequestrants</p> Signup and view all the answers

    What is a primary cause of respiratory acidosis?

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

    Which lung disease is likely to lead to respiratory acidosis?

    <p>Cystic fibrosis</p> Signup and view all the answers

    What physiological change results from hyperventilation?

    <p>Decreased carbon dioxide levels</p> Signup and view all the answers

    What may cause metabolic alkalosis due to loss of hydrochloric acid?

    <p>Self-induced vomiting</p> Signup and view all the answers

    What serum level changes characterize respiratory acidosis?

    <p>Increased carbon dioxide and normal bicarbonate</p> Signup and view all the answers

    Why can excessive use of sodium bicarbonate lead to metabolic alkalosis?

    <p>It decreases hydrogen ion concentration</p> Signup and view all the answers

    Which compensation mechanism is employed by the lungs during metabolic acidosis?

    <p>Increasing respiration rate to eliminate carbon dioxide</p> Signup and view all the answers

    In respiratory alkalosis, which action is taken by the kidneys?

    <p>Excreting bicarbonate and conserving hydrogen ions</p> Signup and view all the answers

    What is the typical ratio of bicarbonate to carbonic acid in a compensated acid-base status?

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

    What primary disorder is characterized by a deficiency in bicarbonate?

    <p>Metabolic acidosis</p> Signup and view all the answers

    What happens when the respiratory system compensates for metabolic alkalosis?

    <p>Decreased ventilation and carbon dioxide retention</p> Signup and view all the answers

    Which system primarily regulates acid-base balance related to carbonic acid?

    <p>The carbonic acid bicarbonate buffer system</p> Signup and view all the answers

    In metabolic alkalosis, what happens to respiration rates?

    <p>Increases to expel carbon dioxide</p> Signup and view all the answers

    When the pH returns to normal due to compensation, it is said to be what?

    <p>Fully compensated</p> Signup and view all the answers

    What is the effect of metabolic acidosis on the body's ventilation rate?

    <p>Increased ventilation to eliminate carbon dioxide</p> Signup and view all the answers

    Which of the following changes occurs in respiratory acidosis regarding bicarbonate levels?

    <p>Bicarbonate levels increase while pH decreases</p> Signup and view all the answers

    What typically triggers the compensation mechanisms in acid-base disorders?

    <p>pH deviations from normal</p> Signup and view all the answers

    What physiological process primarily causes hyperventilation due to anxiety?

    <p>Release of epinephrine</p> Signup and view all the answers

    Which of the following is a risk factor for acid-base imbalances?

    <p>Critically ill patients</p> Signup and view all the answers

    Which of the following correctly describes respiratory alkalosis?

    <p>Decrease in carbon dioxide levels</p> Signup and view all the answers

    Which condition can cause an increase in body metabolism leading to hyperventilation?

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

    What is the most common consequence of cardiac arrest related to acid–base imbalance?

    <p>Respiratory acidosis</p> Signup and view all the answers

    Which factor is crucial in differentiating between metabolic and respiratory acid-base disorders?

    <p>The primary cause of the change in serum pH</p> Signup and view all the answers

    Which of the following can increase the respiratory rate due to elevated body temperature?

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

    What effect does the intentional overdose of salicylate drugs have on respiration?

    <p>Increases respiratory rate</p> Signup and view all the answers

    Which of the following conditions typically results in chronic respiratory acidosis?

    <p>Cystic fibrosis</p> Signup and view all the answers

    In metabolic alkalosis, which factor can contribute to the increase in serum bicarbonate?

    <p>Excess bicarbonate administration</p> Signup and view all the answers

    What is one consequence of severe hypercapnia?

    <p>Respiratory acidosis</p> Signup and view all the answers

    Which of the following would most likely NOT lead to hyperventilation?

    <p>Deep sleep</p> Signup and view all the answers

    Which of these factors does NOT commonly cause a decrease in arterial pH?

    <p>Increased bicarbonate levels</p> Signup and view all the answers

    Acute respiratory conditions may lead to what type of acid-base imbalance?

    <p>Respiratory acidosis</p> Signup and view all the answers

    Study Notes

    Acid-Base Imbalances

    • Acid-base imbalances are categorized as acidosis or alkalosis, arising from a disruption in the 20:1 ratio of acid to base.
    • Imbalances can result from underlying diseases or insufficient compensatory mechanisms.
    • Imbalances are classified as respiratory or metabolic.
    • Metabolic imbalances affect the base, while respiratory ones involve carbonic acid concentration changes.

    Metabolic Acidosis

    • Characterized by decreased pH (below 7.35) and bicarbonate concentration (below 22 mEq/L).
    • Caused by:
      • Increased hydrogen ions:
        • Uncontrolled diabetes (diabetic ketoacidosis)
        • Eating disorders/alcoholism (starvation)
        • Chronic kidney failure
        • Heart failure/sepsis/blood loss/shock/cardiac arrest (lactic acidosis)
        • Excessive exercise (muscle metabolic acidosis)
        • Salicylate toxicity
        • Antidiabetic drugs (lactic acidosis)
        • HIV/AIDS medication (lactic acidosis)
      • Decreased bicarbonate:
        • Severe diarrhea/intestinal fistulas/laxative abuse
        • Drugs that block bicarbonate reabsorption/kidney damage
      • Increased chloride:
        • Bile acid sequestrants
        • Excessive sodium chloride IV fluids

    Metabolic Alkalosis

    • Characterized by increased pH (above 7.45) and bicarbonate concentration (greater than 26 mEq/L).
    • Caused by:
      • Decreased hydrogen ions:
        • Excessive vomiting
      • Decreased chloride:
        • Excessive loop diuretic use
      • Increased bicarbonate:
        • Excessive sodium bicarbonate use

    Respiratory Acidosis

    • Caused by carbon dioxide retention, increasing carbonic acid.
    • Characterized by decreased pH (below 7.35) and increased carbon dioxide partial pressure (above 45 mmHg).
    • Associated with hypoventilation.
    • Example causes:
      • Opiate overdose
      • Lung diseases (COPD, asthma, pneumonia, pulmonary edema)
      • Foreign body aspiration

    Respiratory Alkalosis

    • Caused by carbon dioxide loss (hyperventilation).
    • Characterized by increased pH (above 7.45) and decreased carbon dioxide partial pressure (below 35 mmHg).
    • Associated with hyperventilation.
    • Example causes:
      • Anxiety/pain/stress
      • Thyrotoxicosis (excessive thyroid)
      • Fever, infection, high altitude
      • Salicylate overdose

    Compensation

    • The respiratory and renal systems compensate for each other to restore the 20:1 acid-to-base ratio.
    • Lungs compensate for metabolic imbalances by adjusting ventilation.
    • Kidneys compensate for respiratory imbalances by altering bicarbonate and hydrogen ion levels.
    • Compensation can be partial or full, depending on the extent of pH return to normal.

    Acid-Base Imbalance Clinical Example (Mr. James)

    • Mr. James, a rock climber, suffered a traumatic injury causing significant blood loss.
    • Initial focus is on managing Mr. James's hypovolemia due to blood loss and assessing oxygenation.
    • Priority nursing interventions should involve restoring circulating volume via IV fluids, and checking signs of shock.
    • Confusion/disorientation may result from hypovolemia, hypoxemia, and/or pain-related stress response.
    • Potential diagnostic tests may include blood tests, urinary output and possible chest x-ray.

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    Description

    Test your knowledge on acid-base imbalances, focusing on the distinctions between acidosis and alkalosis, and the role of metabolic and respiratory factors. Understand the causes of metabolic acidosis and its impact on pH and bicarbonate levels.

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