knh 413 acid base balance presentation(1)€¦ · acid-base balance! acids! donate or give up h+...
TRANSCRIPT
![Page 1: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/1.jpg)
Acid-Base Balance
KNH 413
![Page 2: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/2.jpg)
Acid-Base Balance
� Acids� Donate or give up H+ ions
� Nonvolatile acids or fixed acids� Inorganic acids that occur through metabolism of CHO,
protein, lipid
� Average amount 50-100 mmol/day� Proteins contribute the most
� Lungs cannot eliminate
![Page 3: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/3.jpg)
Acid-Base Balance
� Bases
� Can accept or receive H+ ions
� Bicarbonate HCO3
� Kidneys provide primary regulation
![Page 4: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/4.jpg)
![Page 5: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/5.jpg)
Acid-Base Balance
� pH� Acidosis
� Accumulation of acid or loss of base
� Acidemia� pH < 7.35
� Alkalosis� Accumulation of base or loss of acid
� Alkalemia� pH > 7.45
![Page 6: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/6.jpg)
Regulation of Acid-Base Balance
� Chemical buffers
� Respiratory regulation
� Kidney regulation
![Page 7: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/7.jpg)
![Page 8: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/8.jpg)
Regulation of Acid-Base Balance
� Respiratory regulatory control
� Change in respiration rate
� Depth of breathing
� Release or retention of CO2
![Page 9: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/9.jpg)
Regulation of Acid-Base Balance
� Renal regulatory control
� Control of HCO3 by the kidneys� Increased or decreased based on need� Formation of dibasic phosphate and sulfur in the urine
� Accepts H+
![Page 10: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/10.jpg)
![Page 11: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/11.jpg)
Regulation of Acid-Base Balance
� Electrolyte Balance
� Hydrogen and bicarbonate both electrolytes� Other electrolytes affected to maintain electroneutrality� Potassium, chloride, sodium
![Page 12: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/12.jpg)
![Page 13: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/13.jpg)
![Page 14: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/14.jpg)
Acid-Base Disorders
� 4 major types
� Respiratory acidosis� Respiratory alkalosis� Metabolic acidosis� Metabolic alkalosis
![Page 15: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/15.jpg)
![Page 16: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/16.jpg)
Acid-Base Disorders
� Respiratory acidosis� Excess acid in blood secondary to carbon dioxide retention� Hypercapnia� Common causes � d/t respiratory dysfunction – renal regulatory systems
compensate
![Page 17: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/17.jpg)
![Page 18: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/18.jpg)
Acid-Base Disorders
� Respiratory acidosis� Labs
� Decreased pH, elevated pCO3
� Slightly elevated bicarbonate� Increase in serum Ca, K, Cl
� Hypoxemia� Restlessness, apprehension, lethargy, muscle twitching,
tremors, convulsions, coma
![Page 19: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/19.jpg)
Acid-Base Disorders
� Respiratory acidosis
� Treatment
� Correct underlying condition
� Increase oxygenation� Mechanical ventilation
![Page 20: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/20.jpg)
Acid-Base Disorders
� Respiratory alkalosis
� Relative excess amount of base d/t reduction of CO2
� Hyperventilation� Common causes - see Table 9.6� Shift of acid from ICF to ECF � Bicarbonate moved into cells in exchange for chloride –
renal compensation
![Page 21: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/21.jpg)
![Page 22: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/22.jpg)
Acid-Base Disorders
� Respiratory alkalosis
� pH > 7.45 � Plasma HCO3 low in chronic, PaCO3 low in acute� Cardiac, CNS, respiratory symptoms� Treat underlying cause� Correction of hypoxia
![Page 23: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/23.jpg)
Acid-Base Disorders
� Metabolic Acidosis
� All types not caused by excessive CO2
� Common causes � Diarrhea most common cause
� d/t excessive loss of bicarbonate – bicarbonate-carbonic acid buffer system is stimulated
![Page 24: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/24.jpg)
© 2007 Thomson - Wadsworth
![Page 25: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/25.jpg)
![Page 26: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/26.jpg)
![Page 27: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/27.jpg)
![Page 28: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/28.jpg)
Acid-Base Disorders
� Metabolic Acidosis
� Kussmaul breathing� Cardiac and neurological � Treat underlying cause� Raise pH to safe level – not too quickly
![Page 29: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/29.jpg)
Acid-Base Disorders
� Metabolic Alkalosis
� Excess amount of base� Fluid imbalance – with volume decrease� Without fluid imbalance – without volume decrease� Common causes � Underlying event determines pathophysiology
![Page 30: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/30.jpg)
![Page 31: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/31.jpg)
![Page 32: KNH 413 Acid Base Balance Presentation(1)€¦ · Acid-Base Balance! Acids! Donate or give up H+ ions! Nonvolatile acids or fixed acids! Inorganic acids that occur through metabolism](https://reader036.vdocuments.site/reader036/viewer/2022071013/5fcbd13f90a6330f4f66386e/html5/thumbnails/32.jpg)
Assessment of Acid-Base Disorders
© 2007 Thomson - Wadsworth