NUR 425 Exam 3 ACTUAL Questions and CORRECT Answers
True or false: Acid-base imbalance is a False!
disease.
Oxygen is ____ whereas CO2 is ___ _. Alkaline. Acidic.
Hydrogen is __ _. Acidic
HCO3 is __ _. Alkaline
HCl is __ _. Acidic
Glucose is __ _. Acidic
1. Buffer System
-Very quick acting, but doesn't last long
-Made up of proteins, ions, hydrogen, etc.
-Strong acids are made to weaker acids, or vice versa
2. Respiratory System
-Kicks in after a few minutes, lasts up to a day
List the compensatory mechanisms (3) for
-Respiratory rate is altered to either increase O2 intake or increase CO2 retention.
acid-base balance.
3. Renal System
-Kicks in after about a day, more sustainable than the others
-Kidneys will either excrete hydrogen or retain it, and either excrete HCO3 or retain
it, depending on the condition.
-H + HCO3 --> H2CO3 (Carbonic acid) --> H20 + CO2 <--This process can be
reversed
Partial pressure of oxygen in arterial blood
What does PaO2 measure?
Normal: 80-100 mmHg
The percentage of hemoglobin that is saturated with O2
What does SaO2 measure?
Normal: 95-100%
, Partial pressure of CO2 in blood
What does PaCO2 measure? Normal: 35-45 mmHg
Indicates lung function
It measures the bicarbonate concentration in the blood
What does HCO3 measure? Normal: 22-26 mmHg
Indicates kidney function
Normal blood pH 7.35-7.45, which represents the balance between hydrogen ions & bicarbonate ions
-There is one problem but no one is helping.
Describe uncompensated acid-base
-The pH is abnormal and one other value is abnormal.
imbalances.
-One value is normal.
Identify this acid base imbalance as either Uncompensated respiratory acidosis
mixed, uncompensated, partially
compensated, or fully compensated. Also,
identify the type of acid base balance.
pH: 7.28
CO2: 58 mmHg
HCO3: 25 mmHg
-There is a metabolic problem AND a respiratory problem.
Describe mixed acid-base imbalances. -No one is trying to compensate because they are BOTH causing the disturbance.
-All values either indicate acidity, or all values indicate alkalinity.
Identify this acid base imbalance as either This can either be respiratory or metabolic alkalosis with mixed compensation.
mixed, uncompensated, partially Because it is mixed, there are two problems causing an acid base balance. All of the
compensated, or fully compensated. Also, values indicate an alkalinity problem.
identify the type of acid base balance.
pH: 7.52
CO2: 28 mmHg
HCO3: 32 mmHg
-One system is causing the disturbance, and the other system is TRYING to
Describe partially compensated acid-base compensate.
imbalance. -All values are going be abnormal. The pH will help us determine which system is
causing the disturbance.
Identify this acid base imbalance as either Partially compensated respiratory acidosis
mixed, uncompensated, partially
compensated, or fully compensated. Also, The pH is acidic, so the system causing the disturbance is the lungs. The kidneys are
identify the type of acid base balance. retaining bicarbonate to try to balance out the pH, but this is partially compensated
because the pH is still acidic.
pH: 7.25
CO2: 53 mmHg
HCO3: 35 mmHg
-One system is causing the disturbance, the other system is compensating and it
WORKED.
Describe fully compensated acid-be -The pH is going to be normal, but it is going to be on the higher or lower end of a
imbalance. pH.
-7.35-7.4 --> acidic
-7.4-7.45 --> alkaline
, Identify this acid base imbalance as either Fully compensated respiratory acidosis
mixed, uncompensated, partially
compensated, or fully compensated. Also, The pH is in the normal spectrum, but still less than 7.4 so we know the high CO2
identify the type of acid base balance. level is causing the altered pH. The kidneys are retaining bicarbonate to compensate
for the acidic pH, and it WORKED because the pH is now in the normal spectrum.
pH: 7.36
CO2: 50 mmHg
HCO3: 35 mmHg
-Hypoventilation
-Drug overdose
-Pulmonary edema, pneumonia, pulmonary embolism (later stage)
List causes of respiratory acidosis. -Chest trauma
-Neuromuscular disease
-COPD
-Airway obstruction
We need to increase breathing, so...
-Administer narcan for drug overdose
-Reduce sedation
List treatment for respiratory acidosis. -Intubate or change ventilator settings
-Suction
-Administer bronchodilators
-Treat pneumonia, pneumothorax
-DKA
-Salicylate OD
-Shock (Lactic acid increases during shock)
List causes of metabolic acidosis.
-Sepsis
-Diarrhea
-Renal failure (Increased uric acid concentration)
We need to excrete acid or retain HCO3, so...
-Administer sodium bicarbonate
-Encourage Kussmaul respirations or set ventilator settings to do this
List treatment for metabolic acidosis.
-Antidiarrheal medications
-Dialysis
-Insulin
-Hyperventilation
-Initial stages of pulmonary embolism
-Hypoxia
-Fever
List causes of respiratory alkalosis. -Pregnancy
-High altitudes
-Anxiety
-Pain
-Mechanical ventilator causing hyperventilation
We need to decrease RR, so...
-Administer analgesics, anxiolytics, antipyretics
List treatment for respiratory alkalosis. -Stop or reverse drug that is causing increased CNS activation
-Breathe into a paper bag
-Change existing ventilator settings
True or false: Acid-base imbalance is a False!
disease.
Oxygen is ____ whereas CO2 is ___ _. Alkaline. Acidic.
Hydrogen is __ _. Acidic
HCO3 is __ _. Alkaline
HCl is __ _. Acidic
Glucose is __ _. Acidic
1. Buffer System
-Very quick acting, but doesn't last long
-Made up of proteins, ions, hydrogen, etc.
-Strong acids are made to weaker acids, or vice versa
2. Respiratory System
-Kicks in after a few minutes, lasts up to a day
List the compensatory mechanisms (3) for
-Respiratory rate is altered to either increase O2 intake or increase CO2 retention.
acid-base balance.
3. Renal System
-Kicks in after about a day, more sustainable than the others
-Kidneys will either excrete hydrogen or retain it, and either excrete HCO3 or retain
it, depending on the condition.
-H + HCO3 --> H2CO3 (Carbonic acid) --> H20 + CO2 <--This process can be
reversed
Partial pressure of oxygen in arterial blood
What does PaO2 measure?
Normal: 80-100 mmHg
The percentage of hemoglobin that is saturated with O2
What does SaO2 measure?
Normal: 95-100%
, Partial pressure of CO2 in blood
What does PaCO2 measure? Normal: 35-45 mmHg
Indicates lung function
It measures the bicarbonate concentration in the blood
What does HCO3 measure? Normal: 22-26 mmHg
Indicates kidney function
Normal blood pH 7.35-7.45, which represents the balance between hydrogen ions & bicarbonate ions
-There is one problem but no one is helping.
Describe uncompensated acid-base
-The pH is abnormal and one other value is abnormal.
imbalances.
-One value is normal.
Identify this acid base imbalance as either Uncompensated respiratory acidosis
mixed, uncompensated, partially
compensated, or fully compensated. Also,
identify the type of acid base balance.
pH: 7.28
CO2: 58 mmHg
HCO3: 25 mmHg
-There is a metabolic problem AND a respiratory problem.
Describe mixed acid-base imbalances. -No one is trying to compensate because they are BOTH causing the disturbance.
-All values either indicate acidity, or all values indicate alkalinity.
Identify this acid base imbalance as either This can either be respiratory or metabolic alkalosis with mixed compensation.
mixed, uncompensated, partially Because it is mixed, there are two problems causing an acid base balance. All of the
compensated, or fully compensated. Also, values indicate an alkalinity problem.
identify the type of acid base balance.
pH: 7.52
CO2: 28 mmHg
HCO3: 32 mmHg
-One system is causing the disturbance, and the other system is TRYING to
Describe partially compensated acid-base compensate.
imbalance. -All values are going be abnormal. The pH will help us determine which system is
causing the disturbance.
Identify this acid base imbalance as either Partially compensated respiratory acidosis
mixed, uncompensated, partially
compensated, or fully compensated. Also, The pH is acidic, so the system causing the disturbance is the lungs. The kidneys are
identify the type of acid base balance. retaining bicarbonate to try to balance out the pH, but this is partially compensated
because the pH is still acidic.
pH: 7.25
CO2: 53 mmHg
HCO3: 35 mmHg
-One system is causing the disturbance, the other system is compensating and it
WORKED.
Describe fully compensated acid-be -The pH is going to be normal, but it is going to be on the higher or lower end of a
imbalance. pH.
-7.35-7.4 --> acidic
-7.4-7.45 --> alkaline
, Identify this acid base imbalance as either Fully compensated respiratory acidosis
mixed, uncompensated, partially
compensated, or fully compensated. Also, The pH is in the normal spectrum, but still less than 7.4 so we know the high CO2
identify the type of acid base balance. level is causing the altered pH. The kidneys are retaining bicarbonate to compensate
for the acidic pH, and it WORKED because the pH is now in the normal spectrum.
pH: 7.36
CO2: 50 mmHg
HCO3: 35 mmHg
-Hypoventilation
-Drug overdose
-Pulmonary edema, pneumonia, pulmonary embolism (later stage)
List causes of respiratory acidosis. -Chest trauma
-Neuromuscular disease
-COPD
-Airway obstruction
We need to increase breathing, so...
-Administer narcan for drug overdose
-Reduce sedation
List treatment for respiratory acidosis. -Intubate or change ventilator settings
-Suction
-Administer bronchodilators
-Treat pneumonia, pneumothorax
-DKA
-Salicylate OD
-Shock (Lactic acid increases during shock)
List causes of metabolic acidosis.
-Sepsis
-Diarrhea
-Renal failure (Increased uric acid concentration)
We need to excrete acid or retain HCO3, so...
-Administer sodium bicarbonate
-Encourage Kussmaul respirations or set ventilator settings to do this
List treatment for metabolic acidosis.
-Antidiarrheal medications
-Dialysis
-Insulin
-Hyperventilation
-Initial stages of pulmonary embolism
-Hypoxia
-Fever
List causes of respiratory alkalosis. -Pregnancy
-High altitudes
-Anxiety
-Pain
-Mechanical ventilator causing hyperventilation
We need to decrease RR, so...
-Administer analgesics, anxiolytics, antipyretics
List treatment for respiratory alkalosis. -Stop or reverse drug that is causing increased CNS activation
-Breathe into a paper bag
-Change existing ventilator settings
