N4581 Adults with Complex Needs Exam 1 Questions Answered Correctly Latest Update

N4581 Adults with Complex Needs Exam 1 Questions Answered Correctly Latest Update Acid-base regulatory mechanisms in the body - Answers Buffers, respiratory, and the renal systems regulate this Properties of the buffer system - Answers carbonate acid--bicarbonate, phosphate, proteins, and hemoglobin buffers Compensates the fastest out of the three How K+ is affected by acid base imbalances - Answers K+ may be low in alkalosis and high in acidosis (think of electrolyte shifts from inside to outside of cell) Properties of the respiratory system (related to acid-base regulation) - Answers CO2+H2O = H+HCO3 Increasing/decreasing respirations changes CO2 (acid) levels (CO2 readings are an indication of ventilation) Think of Kussmaul's respirations--blowing off CO2 (acid) Takes minutes to hours to compensates Properties of the Renal System Regulation (r/t acid-base regulation) - Answers Kidneys conserve HCO3 and excretes H+ and other weak acids --Combines H+ w/ NH3 Takes days to fully compensate Causes of acute pH imbalances - Answers Sepsis, DKA, ARDs (no compensation) Cause of chronic pH imbalances - Answers Renal failure, COPD (compensation occurs) Causes of acidosis - Answers CNS/respiratory depression, metabolic disturbances (DM1&2--Kussmaul), oversedation, head injury Manifestations of alkalosis - Answers CNS irritability, hypocalcemic symptoms (tingling in lips, muscle spasms) What may waking up with a headache indicate (r/t pH)? - Answers Sleep apnea disrupts breathing-->CO2 builds up--->CO2 causes vasodilation-->headache In respiratory pH disturbances: Acidosis: ___ pH ___ CO2 Alkalosis:___ pH ___ CO2 - Answers Acidosis: _down_ pH _up_ CO2 Alkalosis: _up_ pH _down_ CO2 In metabolic pH disturbances: Acidosis: ___ pH ___ HCO3 Alkalosis:___ pH ___ HCO3 - Answers Acidosis: _down_ pH _down_ HCO3 Alkalosis: _up_ pH _up_ HCO3 Interpret the following: pH: 7.30 CO2: 25 HCO3: 16 Compensated? - Answers pH: 7.30 (LOW, acidosis) CO2: 25 (LOW - 35-45) HCO3: 16 (LOW - 22-26) Compensated? no Metabolic Acidosis Interpret the following: pH: 7.18 PaCO2: 38 PaO2: 70 HCO3: 15 Compensated? - Answers pH: 7.18 (LOW, acidosis) CO2: 38 (Normal - 35-45) PaO2: 70 (LOW - 80-100_=) HCO3: (LOW- 22-26) Compensated? no Metabolic Acidosis Interpret the following: pH: 7.33 PaCO2: 67 PaO2: 47 HCO3: 37 Compensated? - Answers pH: 7.33 (NORMAL) CO2: 38 (HIGH - 35-45) PaO2: 70 (LOW - 80-100) HCO3: 37 (HIGH- 22-26) Compensated? YES Respiratory Acidosis Interpret the following: pH: 7.50 PaCO2: 28 PaO2: 85 HCO3: 24 Compensated? - Answers pH: 7.50 (HIGH) CO2: 28 (LOW- 35-45) PaO2: 85 (NORMAL - 80-100) HCO3: 24 (NORMAL- 22-26) Compensated? NO Respiratory Alkalosis How is K+ affected by acid-base imbalances? What other electrolyte should be checked? - Answers In metabolic acidosis, excess H+ ions are buffered in the cells. Electroneutrality is maintained in part by the movement of intracellular potassium into the extracellular fluid. Thus, metabolic acidosis results in a plasma potassium concentration that is elevated in relation to total body stores. The net effect in some cases is overt hyperkalemia; in other patients who are potassium depleted due to urinary or gastrointestinal losses, the plasma potassium concentration is normal or even reduced. There is still a relative increase in the plasma potassium concentration, however, as evidenced by a further fall in the plasma potassium concentration if the acidemia is corrected. A fall in pH is much less likely to raise the plasma potassium concentration in patients with lactic acidosis or ketoacidosis. The hyperkalemia that is commonly seen in diabetic ketoacidosis, for example, is more closely related to the insulin deficiency and hyperosmolality than to the degree of acidemia Check Ca+ (low pH triggers bone resorption) -- negative correlation with pH, more so in metabolic imbalances than respiratory.