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How Do The Kidneys Compensate Respiratory Acidosis Quizlet

Respiratory Acidosis

Respiratory Acidosis

Respiratory acidosis is a medical emergency in which decreased ventilation (hypoventilation) increases the concentration of carbon dioxide in the blood and decreases the blood's pH (a condition generally called acidosis). Carbon dioxide is produced continuously as the body's cells respire, and this CO2 will accumulate rapidly if the lungs do not adequately expel it through alveolar ventilation. Alveolar hypoventilation thus leads to an increased PaCO2 (a condition called hypercapnia). The increase in PaCO2 in turn decreases the HCO3−/PaCO2 ratio and decreases pH. Terminology[edit] Acidosis refers to disorders that lower cell/tissue pH to < 7.35. Acidemia refers to an arterial pH < 7.36.[1] Types of respiratory acidosis[edit] Respiratory acidosis can be acute or chronic. In acute respiratory acidosis, the PaCO2 is elevated above the upper limit of the reference range (over 6.3 kPa or 45 mm Hg) with an accompanying acidemia (pH <7.36). In chronic respiratory acidosis, the PaCO2 is elevated above the upper limit of the reference range, with a normal blood pH (7.35 to 7.45) or near-normal pH secondary to renal compensation and an elevated serum bicarbonate (HCO3− >30 mm Hg). Causes[edit] Acute[edit] Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs. This failure in ventilation may be caused by depression of the central respiratory center by cerebral disease or drugs, inability to ventilate adequately due to neuromuscular disease (e.g., myasthenia gravis, amyotrophic lateral sclerosis, Guillain–Barré syndrome, muscular dystrophy), or airway obstruction related to asthma or chronic obstructive pulmonary disease (COPD) exacerbation. Chronic[edit] Chronic respiratory acidosis may be secondary to many disorders, including COPD. Hypoventilation Continue reading >>

A9: Acid-base Balance

A9: Acid-base Balance

Sort Carbon dioxide is carried in the blood in all of the following forms, EXCEPT: a. it is physically dissoved in plasma b. some binds with hemoglobin to form carbamino hemoglobin c. some diffuses into the tissues d. some binds with water to form carbonic acid c (Assume the following normal values in answering the following question: pH = 7.4 pCO2 = 40 mmHg Total CO2 = 25.7 mmol/L HCO3 = 24.5 mmol/L H2CO3 = 1.2 mmol/L) A patient has a blood pH of 7.27 and a pCO2 of 62 mmHg. The HCO3- is 24.5 mmol/L. a) Is this a state of acidosis or alkalosis? b) Is the origin of the condition respiratory or metabolic and why? c) What are two conditions that can cause this? d) How will the body compensate? a) A pH of <7.4 is acidosis b) pCO2 is increased, HCO3- is normal so respiratory c) 1. Respiratory depression e.g. barbituate drugs 2. Decreased lung function e.g. pneumonia d) 1. Renal - increased HCO3-resorbtion - increased H+ secretion 2. Respiratory - hyperventilation (Assume the following normal values in answering the following question: pH = 7.4 pCO2 = 40 mmHg Total CO2 = 25.7 mmol/L HCO3 = 24.5 mmol/L H2CO3 = 1.2 mmol/L) A patient has a blood pH of 7.27, a pCO2 of 40 mmHg, [H2CO3] of 1.2 mmol/L and [HCO3-] of 22 mmol/L. a) Is this a state of acidosis or alkalosis? b) Is the origin of the condition respiratory or metabolic and why? c) What are two general causes of this condition and give a specific example of each? d) How will the body try to compensate? a) pH is <7.4 so acidosis b) HCO3is decreased, pCO2 is normal, so metabolic c) 1. Excess loss of HCO3, e.g. diarrhea 2. Accumulation of acids e.g. ketosis d) 1. Renal - increased HCO3- esorbtion - increased H+ secretion 2. Respiratory - hyperventilation In a condition of respiratory acidosis, the kidney will try to compensate Continue reading >>

Acid-base Balance Flashcards | Quizlet

Acid-base Balance Flashcards | Quizlet

occurs when there is an excess of any body acid, except H2CO3 (carbonic acid) what are the two causes of metabolic acidosis? excess acid production can occur as a result of many conditions. what conditions? (4) -diabetic ketacidocis from total absence of insulin in the body -lactic acidosis,lack of oxygen in the tissues which cause production of lactic acid in tissues -kidney diseases, which prevent elimination of acid in the body how excess acid can appear in extracellular fluids? (amount of what where) explain what happens as result of these concentrations -as excess of K+ into cells, H+ comes out -excessive diarrhea, which causes the lose of bicarbonate, which is plentiful in intestinal fluid what happens in emphysema? how affect plasma? -alveolar walls disintegrate over time, producing large air spaces that remain filled with gases during expiration -This condition reduces the surface area in the lung available for exchange of O2 and CO2 -As a result of this process, CO2 becomes trapped in the alveoli and plasma levels of CO2 rise what is the cause of respiratory alkalosis? (2) b. elimination of too much CO2 or build up of CO2 in the body Respiratory alkalosis occurs whe too much CO2 is eliminated form the body because of hyperventilation acidosis 2 reasons? (think about levels of H+, base, HCO3-) alkalosis 2 reasons? (think about levels of H+, base, HCO3-) b. urinary reabsorption and generation of HCO3- cause of acidosis? (respiratory related, what rises) -defective exchange of gases in the lungs chemical equation for reaction between CO2 and H2O As a result of respiration alkalosis, which direction will this reaction go? the equilibrium reaction shifts to the left as CO2 is blown off which of the following would be observed in simple, uncompensated respiratory al Continue reading >>

Are All Answers Assessments Or Implementations?

Are All Answers Assessments Or Implementations?

Diabetic KetoAcidosis (DKA): (5-10% mortality) – Almost exclusively in Type 1 diabetics – S/S: Polyuria, dehydration, ab pain, fruity breath, AMS, ↓ Na/Mg/Phos, ↑K (↓ total body), + following: • Hyperglycemia (>250) • Metabolic acidosis (pH <7.3,> 20) • Ketonuria/Ketonemia – TX: • IV insulin bolus (0.1 unit/kg) then IV infusion with same amount per hr AFTER making sure pt is not ↓ K – Continue until acidosis corrects then taper • NS immediately upon diagnosis – Switch to D5NS when glucose < 250 • Why in the world would I give D5NS when a patient still has high glucose levels? The most important problem is the acidosis that is occurring. To reverse this we give insulin to drive glucose into the cell. Remember that K rushes into the cell along with the glucose, and wherever K can go, H+ can go. Since high levels of H+ in the blood is the cause of the acidosis, we give insulin to drive this H+ intercellularly, thereby reversing acidosis. We can't give insulin if the level of glucose is too low, so we give D5NS to keep levels around 250 so we can give insulin until the acidosis is gone. • Add KCl to IV fluids once K < 5; replenish other electrolytes as necessary; Even though K usually appears high, it most often is total body low and when you give glucose, the K is driven into the cell, and hypokalemia can develop rapidly. Hyperosmolar Hyperglycemic nonketotic syndrome (HHNS): – Severe ↑ Glucose, almost exclusively in Type 2 diabetics – Similar to DKA but usually have much higher glucose (>600) and NO acidosis or ketonuria/ketonemia – Treat with fluids and low dose Insulin infusion – An important distinction is that DKA usually occurs i Continue reading >>

Multiple Choice Quiz 1

Multiple Choice Quiz 1

(See related pages) 1 In which of these compartments is Na+ concentration the lowest? 2 Which statement concerning body fluid composition is correct? A) Intracellular fluid contains a lower concentration of proteins than interstitial fluid. C) Extracellular fluid contains a higher concentration of potassium than intracellular fluid. D) Extracellular fluid contains a higher concentration of sodium than intracellular fluid. 3 Which fluid compartment contains about 67% (by volume) of all body water? 4 The fluid secreted into the stomach by the stomach lining is part of which fluid compartment? 5 In which choice are the major body fluid compartments ranked correctly in order of decreasing volume? A) intracellular, plasma, interstitial B) plasma, interstitial, intracellular C) intracellular, interstitial, plasma D) plasma, intracellular, interstitial 7 In which choice would the person on the left be most likely to have a lower body water content (by percent of body weight) than the person on the right? A) person with 15% body fat / person with 5% body fat 8 Which of these body fluid compartments contains the highest concentration of proteins? 9 Various tissues in the body have different levels of water content. Which of these has the lowest water content by volume? 10 The capillary endothelium separates these two body fluid compartments. 12 A loss of body water would do which of the following? A) increased water reabsorption in the distal convoluted tubules and collecting ducts 19 This hormone directly increases water reabsorption in the kidneys. 25 A small amount of the daily water requirement is met by molecules produced during oxidative phosphorylation in the mitochondria. This is referred to as 42 Which hormone is correctly matched with the results of its hypersecretion? Continue reading >>

How Does The Renal System Compensate For Conditions Of Respiratory Alkalosis?

How Does The Renal System Compensate For Conditions Of Respiratory Alkalosis?

In order to function normally, your body needs a blood pH of between 7.35 and 7.45. Alkalosis is when you have too much base in your blood, causing your blood pH to rise above 7.45. The lungs and the kidneys are the two main organs involved in maintaining a normal blood pH. The lungs do this by blowing off carbon dioxide, since most of the acid in the body is carbonic acid, which is made from carbon dioxide during metabolic processes. The amount of carbon dioxide removed is controlled by your breathing rate. The kidneys maintain blood pH by controlling the amount of bicarbonate, which is a base that is excreted from the body. The kidneys also control the amount of acids excreted from the body. Respiratory alkalosis occurs when the lungs are blowing off more carbon dioxide than the body is producing. This usually occurs from hyperventilation. Your body's immediate response, after about 10 minutes of respiratory alkalosis, is a process called cell buffering. During cell buffering, hydrogen ions found in hemoglobin, proteins and phosphates, move out of the cells and into the extracellular fluid. There they combine with bicarbonate molecules and form carbonic acid. This process helps to reduce the amount of bicarbonate in the body and increase the amount of acid. However, while cell buffering occurs quickly, it does not have a huge effect on the body's pH. After about two to six hours of respiratory alkalosis the kidneys respond. They begin to limit the excretion of hydrogen and other acids and increase the excretion of bicarbonate. It usually takes the kidneys two or three days to reach a new steady state. In chronic respiratory alkalosis, the pH may constantly be high, but the body learns to adapt to it over time, with the help of the kidneys. Continue reading >>

Anps 20 Lab #10

Anps 20 Lab #10

Sort e Compensation of metabolic alkalosis includes which of the following? a. retaining carbon dioxide through the respiratory system b. conserving bicarbonate ion in the renal system c. excreting bicarbonate ion in the renal system d. conserving bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system e. excreting bicarbonate ion in the renal system and retaining carbon dioxide through the respiratory system Continue reading >>

Renal Physiology Acid-base Balance

Renal Physiology Acid-base Balance

Sort Your patient's blood pH is too low (acidosis), caused by metabolic acidosis. After examining the patient, you find that the urine bicarbonate levels are too low (H+ is being reabsorbed) and blood carbon dioxide levels are too high (too much blood acid); What does this mean? Based on the patient's pCO2 levels are they compensating or not? This means that the original problem of a low bicarbonate level needs to be compensated for by the lungs, which need to hyperventilate, expelling more CO2 (an acid). Since this patient's pCO2 levels are also high (not expelling enough acid), they are NOT compensating. Patient's blood pH is too high (alkalosis). This can be caused by either respiratory or metabolic alkalosis. Let's say it is metabolic alkalosis. What do you need to check to see if patient is compensating? If bicarbonate levels are high (too much base) and blood CO2 levels are high (too much acid), what do the lungs need to do to compensate? What does the patient's elevated Pco2 levels tell you? Patients partial pressure of Carbon dioxide and bicarbonate Take shallower breaths to prevent loss of acid Patient is compensating Patient's blood pH is too high (alkalosis). This can be caused by either respiratory or metabolic alkalosis. Let's say it is metabolic alkalosis. What do you need to check to see if patient is compensating? If bicarbonate levels are high (too much base) and blood CO2 levels are low (too little acid), what do the lungs need to do to compensate? Since the patient's pCO2 level is low, this tells you what? Patients pCO2 and bicarbonate Take shallower breaths to prevent loss of acid Not compensating Continue reading >>

Respiratory Acidosis/alkalosis

Respiratory Acidosis/alkalosis

In an attempt ot compensate, the kidneys retain bicarbonate and excrete excess H+ ions into the urine Initially the hyperventilation and respiratory stimulation caause abnormal rapid respirations(tachypnea); in an attempt to compensate, the kidneys excrete excess circulation bicarbonate into the urine. The total concentration of buffer base is lower than normal, with a relative increase in hydrogen ion concentration; thus a greater number of hydrogen ions is circulating in the blood than can be absorbed by the buffer system. A deficit of carbonic acid and a decrease in hydrogen ion concentration that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids. 1.Monitor for signs of respiratory distress. 2.Provide emotional support and reassurance to the client. 3.Encourage appropriate breathing patterns. 4.Assist with breathing techniques and breathing aids as prescribed. a.Encourage voluntary holding of the breath if appropriate b.Provide use of a rebreathing mask as prescribed c.Provide carbon dioxide breaths as prescribed (rebreathing into a paper bag) 5.Provide cautious care with ventilator clients so that they are not forced to take breaths too deeply or rapidly. 6.Monitor electrolyte values, particularly potassium and calcium levels. 8.Prepare to administer calcium gluconate for tetany as prescribed. 1.Monitor for signs of respiratory distress. Continue reading >>

Diabetes Mellitus Nclex Practice Quiz #1 (40 Questions)

Diabetes Mellitus Nclex Practice Quiz #1 (40 Questions)

This exam is all about Diabetes Mellitus! The purpose of this exam is to provide nurses and future nurses an overview of the disease, including its management, impact, and complications. Accomplish this 40-item NCLEX style examination and guarantee a good performance on your NCLEX. Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending. ~ Carl Bard Topics Included topics in this practice quiz are: Guidelines Follow the guidelines below to make the most out of this exam: Read each question carefully and choose the best answer. You are given one minute per question. Spend your time wisely! Answers and rationales are given below. Be sure to read them. If you need more clarifications, please direct them to the comments section. Questions See Also You may also like these quizzes: 3,500+ NCLEX-RN Practice Questions for Free – Tons of practice questions for various topics in the NCLEX-RN! Study Guides Cardiovascular System Respiratory System Nervous System Digestive and Gastrointestinal System Endocrine System Urinary System Homeostasis: Fluids and Electrolytes Cancer and Oncology Nursing Burns and Burn Injury Management Emergency Nursing Miscellaneous Recommended Books and Resources Selected NCLEX-RN review books: MUST HAVE: Saunders Comprehensive Review for the NCLEX-RN® Examination, 7th Edition – A must have book if you're taking the NCLEX-RN. You need to have this. Saunders Strategies for Success for the NCLEX – An invaluable guide that will help you master what matters most in passing nursing school and the NCLEX. Mosby's Comprehensive Review of Nursing for NCLEX-RN – This book has helped nurses pass the NCLEX exam for over 60 years. Practice with over 600 alternative item question formats. Prioritization, Dele Continue reading >>

Res 140

Res 140

Res 140 ex 3 Question Answer Correction of metabolic alkalosis may involve which of the following? D) I, II, and III I. Restoring normal fluid volume II. Administering acidifying agents III. Restoring normal K+ and Cl– levels In order to eliminate the influence of PCO2 changes on plasma HCO3- concentrations, what additional measures of the metabolic component of acid-base balance can be used? D) Standard bicarbonate Which organ system actually excretes H+ from the body? A) Kidneys An ABG result shows the pH to be 7.56 and the HCO3- to be 23 mEq/L. Which of the following is the most likely disorder? D) Respiratory alkalosis What compensates for a metabolic alkalosis? B) Hypoventilation Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.43, PCO2 = 39 mm Hg, HCO3- = 25.1 mEq/L A) Acid-base status within normal limits. What explains the lack of an increased anion gap seen in metabolic acidosis caused by HCO3- loss? A) For each HCO3- ion lost, a Cl- ion is reabsorbed by the kidney. Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.08, PCO2 = 39 mm Hg, HCO3- = 11.8 mEq/L A) Acute metabolic acidosis What affect does hyperventilation have on the closed buffer systems? B) Causes them to release more H+. A patient has a confirmed metabolic acidosis with a normal PCO2. What inference can you draw from these findings? A) A ventilatory disorder must coexist. What drives the bicarbonate buffer systems enormous ability to buffer acids? D) Ventilation continually removing CO2 from system. Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.38, PCO2 = 21 mm Hg, HCO3- = 11.7 mEq/L B) Fully compensated metabolic acidosis With partially compensated respiratory alkalosis, which o Continue reading >>

Compensation In Acid/base Imbalances

Compensation In Acid/base Imbalances

Respiratory compensation for metabolic acidosis (HNC excess) produces systemic hypocapnia (low PCO2). CO2 diffuses from CSF to the body causing the CSF pH to increase. This reduces the central chemoreceptor-stimulated ventilation, partly off-setting the increased stimulation of the peripheral chemoreceptors caused by the low arterial pH. Ventilatory stimulation (low arterial pH acting on peripheral chemoreceptors) Ventilatory inhibition (high CSF pH acting on the central chemoreceptor). What is the overall effect of the ventilatory stimulation and ventilatory inhibition? Respiratory compensation stops short of completely correcting the pH. Respiratory compensation cannot fully restore pH, but the kidney can (for metabolic acidosis anyway). For each H+ that is excreted in the urine (after all of the filtered HCO3- has been reabsorbed), and during ammonia production, new HCO3- enters the body. This added HCO3- titrates excess H+ and over 3 to 4 days the added HCO3- restores pH to 7.4. Renal Compensation Seen on Davenport nomogram Trajectory is along the RC line because as HCO3- is slowly added the pH changes, reducing the stimulation of the respiratory system. Summary of Renal Compensation and Respiratory Compensation PCO2 changes back to normal (renal and respiratory compensation working at the same time) pH and HCO3- change back to normal by sliding up or down the RC line in the Davenport nomogram We can estimate the amount of NC acid that caused a metabolic acidosis by seeing how much HCO3-, HB-, and other NC bases would be needed to fix the problem completely. Also, We can estimate the amount of base needed to restore pH back to normal by hypothetically continuing respiratory compensation. How is base excess/deficit measured on the Davenport nomogram? Base deficit an Continue reading >>

Patho Exam 2 Review

Patho Exam 2 Review

True/False Indicate whether the sentence or statement is true or false. ____ 1. Anaplasia is recognized by loss or organization and a marked increase in nuclear size. ____ 2. A hallmark of cancer cells is their immortality. ____ 3. For the function of tumor suppressor genes to be lost, only one chromosome (allele) of the gene must be inactivated. ____ 4. Most cancers must acquire mutation in six distinct areas: growth signals, antigrowth signals, evading apoptosis, replicating ability, angiogenesis, and invasion and metastasis. ____ 5. There is no current evidence that associates obesity with cancer formation. ____ 6. The term “neoplasm†can refer to a benign tumor. ____ 7. The brain does not require insulin for glucose uptake. ____ 8. Somatostatin produced by the hypothalamus inhibits the release of growth hormone and thyroid stimulating hormone. ____ 9. Adrenocorticotropic hormone (ACTH) directly affects melanocyte stimulation. ____ 10. Aldosterone secretion is stimulated by angiotensin I. ____ 11. Antidiuretic hormone has no direct effect on electrolyte levels. ____ 12. A person with syndrome of inappropriate antidiuretic hormone (SIADH) usually craves cold drinks. ____ 13. Pituitary adenomas are malignant tumors. ____ 14. Abnormal immunologic mechanisms producing autoantibodies are responsible for both Graves’ disease and hypothyroidism. ____ 15. Thyroid carcinoma, although rare, is the most common endocrine malignancy. ____ 16. The most common cause of hypoparathyroidism is damage to the glands during surgery. ____ 17. Individuals with type 2 diabetes mellitus have a greater degree of pancreatic changes than individuals with type 1 diabetes. ____ 18. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by increased levels of anti Continue reading >>

Shared Flashcard Set

Shared Flashcard Set

Details Title patho test 4 Description patho test 4 Total Cards 296 Subject Biology Level Undergraduate 2 Created 03/31/2014 Click here to study/print these flashcards. Create your own flash cards! Sign up here. Additional Biology Flashcards Cards Term What happens in the lungs when the diaphragm relaxes? a. Air is forced out of the lungs. b. Lung volume increases. c. Intrapulmonic pressure decreases. d. Intrapleural pressure decreases. Definition a Term The respiratory mucosa is continuous through the: 1. upper and lower respiratory tracts 2. nasal cavities and the sinuses 3. nasopharynx and oropharynx 4. middle ear cavity and auditory tube a. 1 only b. 1, 2 c. 2, 3 d. 1, 3, 4 e. 1, 2, 3, 4 Definition e Term Which of the following activities does NOT require muscle contractions and energy? a. quiet inspiration b. forced inspiration c. quiet expiration d. forced expiration Definition c Term The maximum volume of air a person can exhale after a maximum inspiration is termed the: a. expiratory reserve volume b. inspiratory reserve volume c. total lung capacity d. vital capacity Definition d Term Which of the following applies to the blood in the pulmonary artery? a. PCO2 is low. b. PO2 is low. c. Hydrostatic pressure is very high. d. It is flowing into the left atrium. Definition b Term Which of the following causes bronchodilation? a. epinephrine b. histamine c. parasympathetic nervous system d. drugs that block beta-2 adrenergic receptors Definition a Term The central chemoreceptors are normally most sensitive to: a. low oxygen level b. low concentration of hydrogen ions c. elevated oxygen level d. elevated carbon dioxide level Definition d Term 97. Which of the following individuals is NOT considered to be at high risk for developing active tuberculosis? a. homeless in Continue reading >>

Renal Ch9 - Acid-base Disorders

Renal Ch9 - Acid-base Disorders

In order to maintain pH Kidneys try to compensate to respiratory acid-base disorders and lungs try to compensate for metabolic disorders Compensation NEVER Over-Corrects pH! (As a rule, compensation restores pH toward normal, but Not completely TO normal) - If pH is acidemic (pH < 7.4), acidosis is the primary acid-base disorder and if pH is alkalemic (pH > 7.4), alkalosis is the primary Compensation in Metabolic Acidosis vs Respiratory Acidosis 1.) In metabolic acidosis (low pH, low HCO3), alveolar ventilation increases creating a respiratory alkalosis (low PCO2) in order to return pH toward the normal range 2.) In Respiratory acidosis (low pH, high PCO2), kidneys excrete H+ and create a metabolic alkalosis (high HCO3) in order to return pH toward the normal range Degree of Compensation: Metabolic Disorders Every 1mmol/L drop in [HCO3] expect 1mmHg drop in PCO2 (from 40) Every 1mmol/L rise in [HCO3] expect 0.6mmHg rise in PCO2 Degree of Compensation: Respiratory Disorders Every 10mmHg rise in PCO2 Expect 1mmol rise in HCO3 Every 10mmHg rise in PCO2 Expect 3.5mmol rise in HCO3 Every 10mmHg fall in PCO2 Expect 2mmol fall in HCO3 Every 10mmHg fall in PCO2 Expect 4mmol fall in HCO3 Mixed Respiratory/Metabolic Acid-Base Disorder May be present if change in PCO2 is inappropriate for change in HCO3 (or vice versa) e.g. Metabolic Acidosis w/ Serum [HCO3] = 16 - if actual PCO2 has dropped 20mmHg --> implies presence of an additional respiratory alkalosis (e.g. metabolic acidosis and respiratory alkalosis in aspirin intoxication) the calculated difference between cations and anions in the blood - roughly equal to the negative charge contributed by proteins Anion Gap is Calculated for 2 Main Reasons 1.) to help determine etiology of a metabolic acidosis 2.) to determine if a com Continue reading >>

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