Clinical Acid Base Flashcards Preview

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Flashcards in Clinical Acid Base Deck (20)
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1
Q

how to determine pH of the body

A

ratio of serum HCO3 and PCO2

henderson hasselbach:
pH=6.1 + log (HCO3/CO2)

2
Q

respiratory acidosis

A

insufficient CO2 excretion by the lungs, high CO2 and low pH

3
Q

respiratory alkalosis

A

excess CO2 excretion, low CO and high pH

4
Q

metabolic acidosis

A

excess metabolic acids consume HCO3, normal CO2

5
Q

metabolic alkalosis

A

loss of metabolic acids causes excess HCO3, normal CO2

6
Q

cause of respiratory acidosis/alkalosis

A

hypoventilation/hyperventilation

7
Q

cause of metabolic acidosis/alkalosis

A

hypoxia, exercise, diabetes, EtOH, diarrhea

emesis, diuretics, excess ingestion of HCO3

8
Q

anion gap equation

A

Na- (Cl+HCO3)

9
Q

meaning of abnormal anion gap

A

abnormal is high, it means HCO3 is being consumed and other anions are in excess

helps identify acid-base insult

10
Q

what is Winter’s formula? and its purpose?

A

to determine if there has been a predictable respiratory compensation to metabolic acidosis

PCO2=1.5 (HCO3) +8 (+or - 2)

11
Q

compensation for respiratory acidosis

A

renal secretion of H+, increase HCO3

takes longer than respiratory compensation

12
Q

compensation for respiratory alkalosis

A

renal retention of H+ and decrease of HCO3

13
Q

compensation for metabolic acidosis

A

increased ventilation increases CO2 excretion, decreases PaCO2

14
Q

compensation for metabolic alkalosis

A

decreased ventilation increases PaCO2

15
Q

indications for invasive positive pressure ventilation

A

hypoxemic respiratory failure- improves V/Q mismatch, reduces work of breathing

hypercarbic respiratory failure

unstable airway in coma or uncontrolled seizure

16
Q

role of PEEP in mechanical ventilation

A

prevent alveolar collapse at end expiration- “positive end expiration pressure”

17
Q

differentiate volume vs pressure modes of mechanical ventilation

A

volume- fixed tidal volume, uses enough pressure to get there

pressure- fixed pressure, tidal volume variable

18
Q

mandatory vs non in mechanical ventilation

A

mandatory- set RR, can be either volume or pressure limited

non- no fixed RR, breaths are pt initiated
-can give pressure support in phases or continuously

19
Q

which settings to focus on for hypoxemia? hypercarbia?

A

FiO2 and PEEP for hypoxemia

minute ventilation (TV and RR) for hypercarbia

20
Q

normal ABG values, bicarb

A

7.4 (+ or - 0..05)/40/85-100, bicarb=24