Respiratory System Compensation Quiz
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Questions and Answers

What occurs to the pH in a patient experiencing respiratory acidosis due to asthma?

  • pH decreases due to elevated carbon dioxide levels (correct)
  • pH increases due to elevated carbon dioxide levels
  • pH remains unchanged during acute episodes
  • pH decreases due to decreased carbon dioxide levels

    • In the context of acid-base balance, which statement correctly defines alkalosis?

  • A condition characterized by an excess of carbonic acid
  • A condition where the pH is less than 7.36
  • A condition where the body compensates by increasing respiratory rate
  • A condition due to accumulation of base or loss of acid (correct)

    • Which physiological response helps compensate for a pH disturbance caused by respiratory failure?

  • Increased respiratory rate to remove CO₂ (correct)
  • Decreased production of lactic acid
  • Increased renal excretion of bicarbonate
  • Decreased oxygen delivery to tissues

    • What is likely indicated by a moderate asthma attack in terms of arterial blood gases (ABGs)?

    <p>pH normal, PaO₂ decreased, PaCO₂ elevated</p> Signup and view all the answers

    What does the term 'hypercapnia' refer to in the context of respiratory acidosis?

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

    Which condition would most likely prevent the correction of acidosis by the respiratory system in an asthma patient?

    <p>Bronchoconstriction and mucus production</p> Signup and view all the answers

    When interpreting ABGs, what finding is typically associated with severe asthma exacerbation?

    <p>Low pH, significantly decreased PaO₂, and increased PaCO₂</p> Signup and view all the answers

    What is the typical magnitude of change in the bicarbonate concentration (HCO₃-) during acute respiratory acidosis due to asthma?

    <p>Decrease in HCO₃- concentration</p> Signup and view all the answers

    What is the primary disturbance in respiratory acidosis?

    <p>Increased PaCO₂</p> Signup and view all the answers

    If a patient presents with a pH of 7.28 and a PaCO₂ of 50 mmHg, what is the probable interpretation?

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

    How does the respiratory system compensate for metabolic acidosis?

    <p>Decrease in PaCO₂</p> Signup and view all the answers

    What indicates adequate compensation for an acid-base disturbance?

    <p>Normalized pH</p> Signup and view all the answers

    In which condition would you expect a pH greater than 7.45?

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

    What is the expected change in HCO₃- levels during respiratory alkalosis?

    <p>Decrease of HCO₃-</p> Signup and view all the answers

    Which ABG result would indicate a compensated respiratory alkalosis?

    <p>pH 7.50, PaCO₂ 30, HCO₃- 24</p> Signup and view all the answers

    What is the likely interpretation of ABGs showing a pH of 7.36, PaCO₂ of 43, and HCO₃ of 22?

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

    What is the primary physiological response to an acute respiratory acidosis in terms of compensation?

    <p>Increase in bicarbonate retention by the kidneys</p> Signup and view all the answers

    In the context of chronic bronchitis, what ABG profile is indicative of compensated respiratory acidosis?

    <p>pH 7.35, PaCO₂ 55 mmHg, HCO₃ 30 mEq/L</p> Signup and view all the answers

    What term best describes the condition when pH is alkalotic, PaCO₂ is low, and HCO₃ is normal?

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

    Which statement about the compensation mechanisms in respiratory acidosis is correct?

    <p>The kidneys increase HCO₃ production.</p> Signup and view all the answers

    In a patient experiencing hyperventilation, what would you expect their ABG results to reflect?

    <p>pH 7.50, PaCO₂ 28 mmHg, HCO₃ 25 mEq/L</p> Signup and view all the answers

    Which ABG value combination is associated with uncompensated metabolic acidosis?

    <p>pH 7.28, PaCO₂ 35 mmHg, HCO₃ 18 mEq/L</p> Signup and view all the answers

    How do the kidneys compensate in a patient with chronic respiratory acidosis?

    <p>By increasing bicarbonate reabsorption</p> Signup and view all the answers

    What condition may result in a low pH, normal HCO₃, and low PaCO₂?

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

    Study Notes

    Learning Objectives

    • Students should be able to describe compensation for pH disturbances by the respiratory system
    • Students should be able to explain compensation for pH disturbances due to respiratory diseases
    • Students should be able to describe respiratory acidosis and respiratory alkalosis
    • Students should be able to interpret ABGs (Arterial Blood Gases) in various clinical disorders

    Patient Presentation

    • Shortness of breath
    • Chest tightness
    • Trouble sleeping due to shortness of breath and coughing
    • Whistling or wheezing sound when exhaling

    Asthma and the Bronchial Tubes

    • Normal bronchial tubes have relaxed smooth muscles
    • Inflamed bronchial tubes (asthma) have tightened smooth muscles, swelling, and mucus buildup in the airways

    ABGs in Acute Asthma

    • Mild: Increased pH, increased PaO2, decreased PaCO2, increased HCO3
    • Moderate: Decreased pH, decreased PaO2, decreased PaCO2, increased HCO3
    • Severe: Decreased pH, decreased PaO2, increased PaCO2, decreased HCO3

    Asthma and Respiratory Acidosis

    • Cellular respiration continuously produces CO2
    • Asthma reduces the lungs' ability to remove CO2
    • CO2 accumulates, leading to increased PaCO2 (hypercapnia)
    • The HCO3-/PaCO2 ratio decreases
    • pH decreases

    Acid-Base Imbalances

    • Acidosis: pH below 7.4, [HCO3]< 24 mEq/L, Pco2 > 40 mmHg
    • Alkalosis: pH above 7.4, [HCO3] > 24 mEq/L, Pco2 < 40 mmHg
    • Metabolic acidosis: Causes decreased bicarbonate levels
    • Respiratory acidosis: Causes increased CO2 levels
    • Metabolic alkalosis: Causes increased bicarbonate levels
    • Respiratory alkalosis: Causes decreased CO2 levels
    • Compensation: Responses to primary acid-base disorders to restore pH to normal

    Normal Arterial Blood Gas Values

    • pH: 7.35-7.45
    • PaCO2: 35-45 mmHg
    • PaO2: 80-100 mmHg
    • HCO3-: 22-26 mEq/L

    Body and pH Homeostasis

    • The body tightly controls pH
    • Extracellular fluid pH is usually 7.4
    • Blood pH is 7.35-7.45
    • Levels below 6.8 or above 8.0 are life-threatening

    Acid-Base Balance

    • pH scale 6.8 - 8.0
    • Normal range 7.35-7.45

    Acid-Base Disturbances

    • Acidosis: due to acid accumulation or base loss
    • Alkalosis: due to base accumulation or acid loss
    • Respiratory acidosis: ventilation dysfunction
    • Metabolic acidosis: gain or loss of non-carbonic acid
    • Simple disorders: single primary event and compensation
    • Mixed disorders: multiple primary events

    Definitions of Acid-Base Terms

    • Acidemia: Low blood pH (< 7.36)
    • Alkalemia: High blood pH (> 7.44)
    • Hypocapnia: Low PaCO2 (< 36 mmHg)
    • Hypercapnia: High PaCO2 (> 44 mmHg)
    • Metabolic acidosis: Decrease in plasma bicarbonate
    • Metabolic alkalosis: Increase in plasma bicarbonate
    • Respiratory acidosis: Increased PaCO2
    • Respiratory alkalosis: Decreased PaCO2
    • Compensatory Processes: Responses correcting primary disorders

    Regulation of Blood pH

    • The body maintains blood pH at 7.35-7.45 using three systems
    • Buffers, respiratory regulation, renal regulation

    Acid-Base Buffer Systems

    • Buffers respond quickly to minor pH changes
    • Respiratory system regulates CO2 levels within minutes
    • Renal system regulates bicarbonate levels in hours to days

    Respiratory Acidosis

    • Symptoms: breathing difficulties, restlessness, rapid shallow breathing, lethargy and disorientation, drowsiness, dizziness
    • Causes: pneumonia, emphysema, asthma, chronic lung disease, pulmonary edema, respiratory depression
    • Elevated PaCO2, normal or near-normal blood pH, elevated HCO3

    Causes of Respiratory Acidosis

    • Airway obstruction
    • Lung diseases
    • Respiratory center depression
    • Extrapulmonary thoracic diseases
    • Neural diseases

    Causes of Acidosis (Hypoventilation)

    • Drug overdose
    • Pulmonary edema
    • COPD
    • Chest trauma
    • Neuromuscular disease

    Decreased Ventilation Mechanism

    • Decreasing ventilation increase arterial Pco2
    • Increasing plasma CO2 lower blood pH
    • Chemoreceptors respond and increase ventilation

    Compensation

    • Metabolic compensation in response to respiratory problem
    • Respiratory compensation in response to metabolic problem
    • Compensation mechanisms are slower or faster

    Causes of Alkalosis (Hyperventilation)

    • Anxiety
    • High altitudes
    • Initial stages of pulmonary emboli (blood clot in lungs)
    • Hypoxia (lack of oxygen)
    • Pregnancy
    • Fever

    Causes of Alkalosis

    • Loss of gastric juices
    • Overuse of antacids
    • Potassium wasting diuretics

    Compensation Speed

    • Respiratory compensation is fast (12-24 hours)
    • Metabolic compensation is slow (5-7 days)

    Chemical Buffers

    • On-scene, handle minor acid-base imbalances

    Respiratory Compensation

    • Affects CO2 regulation quickly

    Renal Compensation

    • Regulates bicarbonate to combat hydrogen losses
    • Slowest compensation (up to 5 days)

    Arterial Blood Gas (ABG) Analysis Steps

    • Step 0: Is the ABG authentic?
    • Step 1: Determine if acidemia or alkalemia
    • Step 2: Identify if respiratory or metabolic
    • Step 3: Determine if acute or chronic (if respiratory)
    • Step 4: Assess compensation adequacy
    • Step 5: Identify if metabolic etiology is anion gap
    • Step 6: Further evaluate high-gap metabolic acidosis

    Interpreting an ABG Strip

    • Step 1: Assess the pH
    • Step 2: Assess the PaCO2 level
    • Step 3: Assess the HCO3 value

    Identifying Primary Process (Diagram)

    • Diagram helps visualize if acidemia or alkalemia and associated causes

    ABG Analysis Table (Primary and Secondary Responses

    • Table shows pH's, [H+] levels and primary vs secondary responses

    Case examples (ABGs Practice Problems)

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    Lec4 Respiratory compensation mechanism PDF

    Description

    Test your knowledge on how the respiratory system compensates for pH disturbances, particularly in respiratory diseases like asthma. This quiz covers concepts such as respiratory acidosis and alkalosis, and interpretation of ABGs in clinical contexts. Understand the physiological changes in bronchial tubes during asthma and apply this knowledge to patient presentations.

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