Bicarb, hydrogen, and carbon dioxide
What are the major chemicals you have to remember with acid-base balance?
Carbon dioxide, acid
What is the major lung chemical and is it a acid or base?
Bicarb (base), Hydrogen (acid)
What are the kidneys chemicals and are they an acid or base?
make you sick or compensate. It depends on which imbalance you have.
The chemical of acid base can either?
If the blood is acidic, alkaline, or neutral.
What does the pH tell you about the blood?
7.35-7.45
What is the normal pH range?
Acidosis
If pH is below 7.35 it is?
Alkalosis
If the pH is above 7.45 it is?
Brain
What organ does not like it when the pH is messed up?
Through the urine (Hydrogen)
How does the kidneys normally remove acid?
Will hold on to it or excrete it depending on the pH
What does your kidneys normally do with the bicarb?
Takes hours to days to do its job
How long does it take for the kidney to do its job normally?
exhalation
How does the lungs normally get ride of CO2?
Retaining CO2
When hypoventilation is occurring what is happening to the CO2?
Eliminate the CO2
When hyperventilation is occurring what is happening to the CO2?
Lungs respond fast.
How long does it take for the lungs to do its job?
A lung problem, CO2 is the chemical causing the problem because there is to much of it in the body.
Describe Respiratory Acidosis?
They are hypoventilating
In Respiratory Acidosis how are the lungs acting?
The kidneys will compensate. Need to remove acid. The body will excrete hydrogen and hold onto bicarb.
How is the body compensating in Respiratory Acidosis?
Anything causes retaining of CO2.
Mid abdominal incision, narcotics, sleeping pills, pneumothorax, collapsed lung, and pneumonia.
What can cause Respiratory acidosis?
Headache, confusion, sleepy.
If not corrected could lead to a coma
Hypoxic.
What are signs and symptoms of Respiratory acidosis?
Restlessness and tachycardia
What are the early signs and symptoms of hypoxia?
Give them OXYGEN
What intervention should be done for hypoxia?
Increase CO2=decrease LOC
Increase CO2= decrease O2
What happens to a patients LOC and O2 when there CO2 increases? (testing strategy)
hypoxia
When you see restlessness what should you think first (testing strategy)?
Get rid of secretions by postural drainage, percussion (vibration therapy), deep breathing exercises, suctioning, fluids, elevate HOB, and incentive spirometry. Then lastly oxygen if needed
How do you treat Respiratory acidosis in patients with pneumonia?
Will have a chest tube (monitor it)
Then oxygen if needed.
How do you treat Respiratory acidosis in patients with pneumothorax?
Turn, cough and deep breaths.
Then lastly oxygen if needed.
How do you treat Respiratory acidosis in post-op patients?
Fix the breathing problem
Whats the main thing to remember for treating Respiratory acidosis?
80-100 mmHg
Normal lab values for PaO2?
35-45 mmHg
Normal lab value for PaCO2?
22-26 mEq/L
Normal lab value for HCO3 (bicarbonate)?
Lung
Respiratory Alkalosis which organ is sick?
Kidney.
Kidney excretes bicarb and retain hydrogen.
Respiratory Alkalosis which organ will compensate and how?
Losing CO2
In Respiratory Alkalosis whats the problem chemical but how?
Hyperventilating
How are the lungs acting in Respiratory Alkalosis?
High
Is the pH high or low in Respiratory Alkalosis?
Hyperventilation
Hysterical, acute aspirin overdose (the client is breathing to fast and therefore, removing CO2(acid)).
Situation:hysterical client
What causes Respiratory Alkalosis?
Lightheaded, faint, peri-oral numbness (mouth), numbness and tingling in the fingers and toes
What are signs and symptoms of Respiratory Alkalosis?
Do not wait for the kidneys to kick in.
Breathe into a paper bag
May have to sedate client to decrease respiratory rate
Treat the cause
Monitor ABGs
How do you treat Respiratory Alkalosis?
Kidney
What organ is sick in Metabolic Acidosis?
The Lungs
By blowing off CO2
What organ will compensate in Metabolic Acidosis and how?
Bicarb and Hydrogen.
The client is retaining hydrogen (acid) or does not have enough bicarb (base)
What is the problem chemical with Metabolic Acidosis and how?
LOW
Is the pH low of high in Metabolic Acidosis?
Respiratory rate will increase to blow off CO2 which is an acid. To help change the amount of acid in the blood.
What will happen to the resp rate in Metabolic Acidosis and why?
-DKA, Starvation (In both cells are starving for glucose, so the body will break down protein and fat, and produce ketones. Ketones are acid.)
-Renal Failure (can no longer filter)
-Severe diarrhea (losing base)
What are cause of Metabolic Acidosis and how?
Depend on the cause
Hyperkalemia
-muscle twitching, muscle weakness, flaccid paralysis and arrthymias
Increased Respiratory Rate
What are signs and symptoms of Metabolic Acidosis?
Treat the Problem/cause
IV push Sodium Bicarb
How do you treat Metabolic Acidosis?
In both cells are starving for glucose, so the body will break down protein and fat, and produce ketones. Ketones are acid.
How does DKA and starvation cause Metabolic Acidosis?
Kidney
What organ is sick in Metabolic Alkalosis?
The lungs, they will hold onto CO2 because it is a acid by hypoventilating causing there to be more acid in the blood.
What organ compensates in Metabolic Alkalosis and how?
Bicarb and Hydrogen. In alkalosis, they are retaining to much base (bicarb) and excreting hydrogen.
What are the problem chemicals in Metabolic Alkalosis and how?
High
Is the pH high or low in Metabolic Alkalosis?
Loss of upper GI contents (vomiting, NG tube suction)
To many antacids (to much base)
To much IV bicarb
What causes Metabolic Alkalosis?
Depends on cause.
Observe LOC
monitor for muscle cramps and life threatening arrthymias
What are signs and symptoms of Metabolic Alkalosis?
It goes down
What happens to serum K in Metabolic Alkalosis?
It goes up
What happens to serum K in Metabolic Acidosis?
Fix the problem/cause
Replace potassium
What is the treatment for Metabolic Alkalosis?
Hyperkalemia
When you think metabolic acidosis, it also equals? (test strategy)
Hypokalemia
When you think Metabolic Alkalosis, it also equals? (test strategy)