Disorders Of Acid-base Balance
Learning Objectives By the end of this section, you will be able to: Identify the three blood variables considered when making a diagnosis of acidosis or alkalosis Identify the source of compensation for blood pH problems of a respiratory origin Identify the source of compensation for blood pH problems of a metabolic/renal origin Normal arterial blood pH is restricted to a very narrow range of 7.35 to 7.45. A person who has a blood pH below 7.35 is considered to be in acidosis (actually, “physiological acidosis,” because blood is not truly acidic until its pH drops below 7), and a continuous blood pH below 7.0 can be fatal. Acidosis has several symptoms, including headache and confusion, and the individual can become lethargic and easily fatigued. A person who has a blood pH above 7.45 is considered to be in alkalosis, and a pH above 7.8 is fatal. Some symptoms of alkalosis include cognitive impairment (which can progress to unconsciousness), tingling or numbness in the extremities, muscle twitching and spasm, and nausea and vomiting. Both acidosis and alkalosis can be caused by either metabolic or respiratory disorders. As discussed earlier in this chapter, the concentration of carbonic acid in the blood is dependent on the level of CO2 in the body and the amount of CO2 gas exhaled through the lungs. Thus, the respiratory contribution to acid-base balance is usually discussed in terms of CO2 (rather than of carbonic acid). Remember that a molecule of carbonic acid is lost for every molecule of CO2 exhaled, and a molecule of carbonic acid is formed for every molecule of CO2 retained. Metabolic Acidosis: Primary Bicarbonate Deficiency Metabolic acidosis occurs when the blood is too acidic (pH below 7.35) due to too little bicarbonate, a condition called primary bicar Continue reading >>
Types Of Disturbances
The different types of acid-base disturbances are differentiated based on: Origin: Respiratory or metabolic Primary or secondary (compensatory) Uncomplicated or mixed: A simple or uncomplicated disturbance is a single or primary acid-base disturbance with or without compensation. A mixed disturbance is more than one primary disturbance (not a primary with an expected compensatory response). Acid-base disturbances have profound effects on the body. Acidemia results in arrythmias, decreased cardiac output, depression, and bone demineralization. Alkalemia results in tetany and convulsions, weakness, polydipsia and polyuria. Thus, the body will immediately respond to changes in pH or H+, which must be kept within strict defined limits. As soon as there is a metabolic or respiratory acid-base disturbance, body buffers immediately soak up the proton (in acidosis) or release protons (alkalosis) to offset the changes in H+ (i.e. the body compensates for the changes in H+). This is very effective so minimal changes in pH occur if the body is keeping up or the acid-base abnormality is mild. However, once buffers are overwhelmed, the pH will change and kick in stronger responses. Remember that the goal of the body is to keep hydrogen (which dictates pH) within strict defined limits. The kidney and lungs are the main organs responsible for maintaining normal acid-base balance. The lungs compensate for a primary metabolic condition and will correct for a primary respiratory disturbance if the disease or condition causing the disturbance is resolved. The kidney is responsible for compensating for a primary respiratory disturbance or correcting for a primary metabolic disturbance. Thus, normal renal function is essential for the body to be able to adequately neutralize acid-base abnor Continue reading >>
Acid Base Statuses
A B Metabolic Acidosis (1) results from cold stress Respiratory Alkalosis (1) results from excessive CO2 blown off Body decr carbonic acid (1) results in slow respirations so that CO2 is retained Acidosis (1) symptoms (a) CNS depression (b) errors in judgment (c) disorientation (d) drowsiness (e) stupor (f) coma Hydrogen Ions excess (1) results in acidosis as pH falls below 7.35 (2) hydrogen ions are forced into the cells causing K+ to move into the cells Diabetic Ketoacidosis metabolic acidosis Metabolic Acidosis dehydration after an extended bout of diarrhea COPD respiratory acidosis Diarrhea (1) respirtory acidosis Anxiety (1)results in respiratory alkalosis (2) associated w/hyperventilation (2) during hyperventilation CO2 is blown off which lowers the amount of acid in the system Severe Asthma Respiratory Alkalosis Acute Renal Failure (1) metabolic acidosis (2) hypermagnesemia (3) hyperkalemia (4) hypocalcemia Diarrhea (1) metabolic acidosis (2) leads to meta acid because there is an over-elimination of bicarbonate Alkalosis (1) signs (a) tingling fingers, toes & face (b) estreme nervousness (c) twitching of muscles (d) tetany Severe Asthma respiratory acidosis Vomiting (1) metabolic alkalosis (2) leads to metabolic alkalosis as hydrochloric acid is lost from the stomach Aspirin metabolic acidosis Overdose of Morphine respiratory acisosis Vigorous Diuresis metabolic alkalosis End Stage Muscular Distrophy respiratory acidosis Severe Hypokalemia metabolic alkalosis Renal Failure (1) results in metabolic acisosis as fluid build up turns acidic Shock (1) metabolic acidosis (2) meta acid because acid is added to the system (3) anaerobic metabolic pathways result in lactate and hydrogen irons (forming lactic acid) Hyperventilation (1) respiratory alkalosis (2) leads to re Continue reading >>
Acid-base Balance And Blood Ph
Acid-base Balance and pH Blood pH The term pH means potentials of Hydrogen. Acidity and alkalinity are expressed on the pH scale, which ranges from 0 (strongly acidic) to 14 (strongly basic, or alkaline). A pH of 7.0, in the middle of this scale, is neutral. Blood is normally slightly basic, alkaline, with a pH range of 7.35 to 7.45. To function properly, the body maintains the pH of blood close to 7.40. An important property of blood is its degree of acidity and alkalinity, and this is referred to as acid-base balance. The acidity or alkalinity of the blood is indicated on the pH scale. - The acidity level increases when the level of acidic compounds in the blood rises or when the level of alkaline compounds in the blood falls. Alkalinity levels increases with the reverse process. - The level of acidic or alkaline compounds in the body rises through increased intake, production, or decreased elimination and falls through decreased intake, production, or increased elimination. The Importance of Blood pH Blood pH and Cell Health; we live and die at a cellular level. The blood pH has a serious effect on all of the body’s systems and the body uses different mechanisms to control the blood’s acid-base balance. The blood’s acid-base balance is controlled by the body because even minor deviations from the normal range can severely affect the brain, arteries, the heart, muscles, and many organs. It can contribute to overwhelming the body leading to serious disease such as cancer. “Inflammatory disorders often increase the risk of cancer” - Merck: Risk Factors for Cancer “If the pH deviates too far in either direction, cells become poisoned by their own toxic waste and die. An imbalance pH can cause serious health problems and can lead to the progression of most deg Continue reading >>
Help! I’m Diagnosed With Acidosis, How Do I Alkalize My Body?
I just had a great conversation with Connie, a sales rep for a Search Optimization Company. The reason for her call was to help our Health Alkaline website with its SEO efforts. However that’s not the first thing she mentioned. Immediately when I answered the call, she started asking questions about alkaline water. “How do I get my body alkaline?” and “How does alkaline water help get my body alkaline?” were two of her most pressing questions. Connie told me her doctor had recently diagnosed her having acidosis. That’s a serious circumstance for her. Read my answer to her below, but first let’s look at what acidosis is. Acidosis is a condition in which there is excessive acid in the body fluids. It is the opposite of alkalosis (a condition in which there is excessive base in the body fluids). According to the U.S. National Library of Medicine and National Institutes of Health, acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory acidosis or metabolic acidosis. Respiratory acidosis develops when there’s too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused by a decreased ability to remove carbon dioxide from the body through effective breathing. This is probably not the type of acidosis she has. Connie’s was probably more related to her diet because her doctor advised her to dramatically cut back her sugar and meat intake. The other acidosis is Metabolic acidosis. This type develops when too much acid is produced or when the kidneys cannot remove enough acid from the body. I hope Connie is reading this… There are several types of metabolic acidosis: Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodie Continue reading >>
Is Your Fatigue Related To Acidosis?
Have you ever experienced extreme fatigue, felt like you could not recover from exercise, or even get your energy up enough to go exercise? Everyone says exercise is so good for the body! Why cant I get motivated? It may be because you have excess lactic acid built up in your system. Any impairment in your bodys ability to utilize oxygen efficiently can cause lactic acid to build up in your system and cause dysfunction. The body has an incredible mechanism for making energy even when we are oxygen deprived. An example of when we are oxygen deprived, is when we are working out hard and increasing our bodys oxygen demands. When this function becomes overwhelmed, lactic acid can build up in the muscles and tissues and cause extreme fatigue and acidosis. This article will dive into how this works and you will discover if your fatigue is related to acidosis. Lactic acidosis is a condition that occurs due to the accumulation of excess lactic acid in the blood. A human body typically has a pH level that is slightly basic or alkaline. Excess acid causes this pH to decrease and makes the pH level acidic. This is a very dangerous state for the body to be in because the function of each cell, tissue, and organ is significantly impaired. The body has many internal mechanisms in place to tightly regulate the bloods pH level and the slightest change in this level can result in severe organ dysfunction. Conditions that decrease blood oxygen levels, interfere with the mitochondria, or decrease the clearance of lactic acid can allow lactic acid to increase to harmful levels ( 3 ). Lactate is produced by anaerobic glycolysis, which means that glucose is metabolized without oxygen through a process known as lactic acid fermentation, in order to produce energy. This is a deviation from th Continue reading >>
Lactic Acidosis – Fatigued, Confused, Grumpy? This Might Be Why.
Many people with gut issues suffer from cogitative issues and body-wide symptoms, along with the gastrointestinal hell they’re going through. One of the reasons is often high levels of D-lactic acid. A few definitions acidosis – an abnormal decrease in pH levels. If systemic this is usually only a tenth of a pH level, or so, high. lactic acid (lactate) – an organic compound formed from fermentation, as well as by humans during normal metabolism and exercise. There are two main types discussed here D-lactic acid and L-lactic acid (two mirror-image isomers), DL-lactic acid is a mixture of the two in equal amounts. See Wikipedia for more information on D&L chirality prefixes. L-lactic acid – the type produced in the human body and the primary type found in the human diet. This form is easy for the body and rarely accumulates at a rate higher than the bodies ability to remove it. Short term acidosis is possible from l-lactic acid with extended strenuous exercise, but is usually cleared within a few hours. Acidosis can also occur with organ failure and other illness. D-lactic acid – this type is mostly foreign to the body and difficult to remove. It can easily build up, when it does this is called lactic acidosis. This article will refer it to as d-lactic acidosis to distinguish Lactate – In this context – the conjugate base of lactic acid, the two terms are used interchangeably. Lactic acid actually isn’t the real culprit that causes the fatigue, brain fog, etc. (see below for symptoms). When lactic acid is formed in the body (by us during exercise, or by bacteria) hydrogen ions are formed, hydrogen ions lower the pH (make it acidic), hydrogen is the true culprit. Excess hydrogen causes problems of its own, but the increased systemic acidity is what causes m Continue reading >>
Lactic Acidosis – What You Can Do About It
When we hear of lactate, lactic acidosis, or lactic acid as it is more commonly known, we usually think of it as a side effect of physical exercise. Activities such as sprinting and lifting weights are designed to increase speed, strength, and muscle mass, the goal of many athletes. Unfortunately, lactic acid buildup can leave us feeling quite the opposite, particularly after unaccustomed exercise. Tight, tired, and painful muscles can hinder our movements for days until the circulation improves and the body has filtered out excess acids. Why does the body produce lactic acid? The answer lies in our muscles’ need for energy. To create this energy, our bodies need oxygen. If the body cannot get enough oxygen, it produces lactic acid, converting it into energy. However, if the lactic acid is not all used up, it will accumulate in the bloodstream, causing “acidosis” – too much acid in the body. Sports coaches may say that athletes just need to learn how to manage their production of lactic acid, by creating what they need and using it all up, so acidosis doesn’t happen. This is not so easy to accomplish, especially for “weekend warriors” – if acid constantly builds up in the body and is not converted into energy, then the muscles are constantly tired, tight, and painful. But, the story about lactic acid production and consumption does not end there, as we will see. Exercise is not the only cause of lactic acidosis When we look into it further, we find that there are two types of lactic acidosis: Type A and Type B. Type A is the result of cells being deprived of oxygen. This is what, in essence, we have referred to above, but can also include anemia or even carbon monoxide poisoning. Type B is where we begin to understand that there is another side to lactic Continue reading >>
Acidosis - metabolic Metabolic acidosis is a condition in which there is too much acid in the body fluids. Causes Metabolic acidosis occurs when the body produces too much acid. It can also occur when the kidneys are not removing enough acid from the body. There are several types of metabolic acidosis. Diabetic acidosis develops when acidic substances, known as ketone bodies, build up in the body. This most often occurs with uncontrolled type 1 diabetes. It is also called diabetic ketoacidosis and DKA. Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body. This can occur with severe diarrhea. Lactic acidosis results from a buildup of lactic acid. It can be caused by: Other causes of metabolic acidosis include: Kidney disease (distal renal tubular acidosis and proximal renal tubular acidosis) Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol Symptoms Most symptoms are caused by the underlying disease or condition that is causing the metabolic acidosis. Metabolic acidosis itself most often causes rapid breathing. Acting confused or very tired may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, ongoing (chronic) condition. Exams and Tests These tests can help diagnose acidosis. They can also determine whether the cause is a breathing problem or a metabolic problem. Tests may include: Arterial blood gas Basic metabolic panel, (a group of blood tests that measure your sodium and potassium levels, kidney function, and other chemicals and functions) Urine pH Lactic acid test Arterial blood gas analysis Other tests may be needed to determine the cause of the acidosis. Treatment Treatment is aimed at the health problem causing the acidosis. In some cas Continue reading >>
Metabolic Acidosis Nclex Review Notes
Are you studying metabolic acidosis and need to know a mnemonic on how to remember the causes? This article will give you a clever mnemonic and simplify the signs and symptoms and nursing interventions on how to remember metabolic acidosis for nursing lecture exams and NCLEX. In addition, you will learn how to differentiate metabolic acidosis from metabolic alkalosis. Don’t forget to take the metabolic acidosis and metabolic alkalosis quiz. This article will cover: Metabolic acidosis simplified Lab values expected with metabolic acidosis Causes of metabolic acidosis Signs and symptoms of metabolic acidosis Nursing interventions for metabolic acidosis Lecture on Metabolic Acidosis Metabolic Acidosis Metabolic Acidosis in Simple Terms: a metabolic problem due to the buildup of acid in the body fluids which affects the bicarbonate (HCO3 levels) either from: increased acid production (ex: DKA where ketones (acids) increase in the body which decreases bicarbonate) decreased acid excretion (ex: renal failure where there is high amount of waste left in the body which causes the acids to increase and bicarb can’t control imbalance) loss of too much bicarb (diarrhea) When this acidic phenomena is taking place in the body other systems will try to compensate to increase the bicarb back to normal. One system that tries to compensate is the respiratory system. In order to compensate, the respiratory system will cause the body to hyperventilate by increasing breathing through Kussmaul’s respirations. Kussmaul respirations are deep, rapid breathes. The body hopes this will help expel CO2 (an acid) which will “hopefully” increase the pH back to normal. Lab values expected in Metabolic Acidosis: HCO3: decreased <22 Blood pH: decreased <7.35 CO2: <35 or normal (may be normal b Continue reading >>
The Importance Of Having A Normal Body Ph
Reset Have you ever wondered what normal body ph is? Have you ever wondered if your body was unhealthy and had a normal body ph? Well, this article concerning normal body ph. is for you. Keep reading to learn about normal body ph and how it’s affecting you. One of the key determinants of the speed of aging and onset of degenerative diseases is the internal biochemistry and terrain of the body. Internal biochemistry is best measured and discussed in terms of the pH. pH is a measurement of the amount of acid and base. It ranges from 1 to 14, with 1 being extremely acidic, and 14 being extremely basic. A neutral state has a pH of 7. There are many environmental factors that can affect the body’s pH and it is vital for all bodily function to maintain a normal body pH. The term acidosis is and only meant to convey a shift in total body chemistry towards the acidic direction. Keep reading to learn more about normal body ph and acidosis. What is the Normal Body pH? According to the research of Dr. Enderlein, our bodies can only be healed of any chronic illness when our blood is at a normal, slightly alkaline pH. What exactly does pH mean? pH is the short form for potential hydrogen. The pH of any solution is the measure of its hydrogen-ion concentration. The higher the pH reading, the more alkaline and oxygen rich the fluid is. The lower the pH reading, the more acidic and oxygen deprived the fluid is. The pH ranges from 0 to 14, with 7.0 being neutral. The indicator above 7.0 is alkaline and below 7.0 is considered acidic. So, what is normal body ph for us? keep reading to find out if you have a normal body ph. Our blood pH has a very narrow range of around 7.35 to 7.45. If our body’s pH deviates from this range, we will be sick or have symptoms of falling sick. If our Continue reading >>
Metabolic acidosis is a condition that occurs when the body produces excessive quantities of acid or when the kidneys are not removing enough acid from the body. If unchecked, metabolic acidosis leads to acidemia, i.e., blood pH is low (less than 7.35) due to increased production of hydrogen ions by the body or the inability of the body to form bicarbonate (HCO3−) in the kidney. Its causes are diverse, and its consequences can be serious, including coma and death. Together with respiratory acidosis, it is one of the two general causes of acidemia. Terminology : Acidosis refers to a process that causes a low pH in blood and tissues. Acidemia refers specifically to a low pH in the blood. In most cases, acidosis occurs first for reasons explained below. Free hydrogen ions then diffuse into the blood, lowering the pH. Arterial blood gas analysis detects acidemia (pH lower than 7.35). When acidemia is present, acidosis is presumed. Signs and symptoms Symptoms are not specific, and diagnosis can be difficult unless the patient presents with clear indications for arterial blood gas sampling. Symptoms may include chest pain, palpitations, headache, altered mental status such as severe anxiety due to hypoxia, decreased visual acuity, nausea, vomiting, abdominal pain, altered appetite and weight gain, muscle weakness, bone pain, and joint pain. Those in metabolic acidosis may exhibit deep, rapid breathing called Kussmaul respirations which is classically associated with diabetic ketoacidosis. Rapid deep breaths increase the amount of carbon dioxide exhaled, thus lowering the serum carbon dioxide levels, resulting in some degree of compensation. Overcompensation via respiratory alkalosis to form an alkalemia does not occur. Extreme acidemia leads to neurological and cardia Continue reading >>
Free Nursing Flashcards About Acid-base/fluid-elec
How does the body compensate for Respiratory Acidosis? Kidneys retain bicarb & release H+ to increase ph How does the body compensate for Respiratory Alkalosis? The kidneys retain H+ and excretee bicarb to decrease pH How does the body compensate for Metabolic Acidosis? Respiration increase to decrease the CO2 which lowers carbonic acid, which increases bicarb and pH How does the body compensate for Metabolic Alkalosis? Respirations decrease which increases CO2, causing carbonic acid to increase and pH to decrease What actions in the body causes Respiratory Acidosis? decreased respiration causes increase in CO2 and carbonic acid, which decreases bicarb and pH... What actions in the body causes Respiratory Alkalosis? Increased respiration causes a decrease in CO2 and carbonic acid, which increases bicarb and pH... What actions in the body causes Metabolic Acidosis? Decreased bicarb (from diarrhea, DKA or renal failure) causes increased carbonic acid and decreased pH... What actions in the body causes Metabolic Alkalosis? Increased bicarb (from prolonged vomiting, diuretics, antacids) causes a decrease in carbonic acid and increased pH... What is the normal range for HCO3 (bicarb)? What is the problem if the CO2 drops below 35? What is the problem if the CO2 rises above 45? What is the problem if the bicarb drops below 22? What is the problem if the bicarb rises above 26? What is the problem if the pH drops below 7.35? What is the problem if the pH rises above 7.45? Where is Na+ more concentrated...ECF or ICF? Where is K+ more concentrated...ECF or ICF? What is magnesium (Mg2+) responsible for? What is phosphorus (PO4) responsible for? What is bicarbonate (HCO3) responsible for? It a buffer to regulate acid-base balance Which area (blood volume or cellular level) does Is Continue reading >>
What Is Metabolic Acidosis?
Metabolic acidosis happens when the chemical balance of acids and bases in your blood gets thrown off. Your body: Is making too much acid Isn't getting rid of enough acid Doesn't have enough base to offset a normal amount of acid When any of these happen, chemical reactions and processes in your body don't work right. Although severe episodes can be life-threatening, sometimes metabolic acidosis is a mild condition. You can treat it, but how depends on what's causing it. Causes of Metabolic Acidosis Different things can set up an acid-base imbalance in your blood. Ketoacidosis. When you have diabetes and don't get enough insulin and get dehydrated, your body burns fat instead of carbs as fuel, and that makes ketones. Lots of ketones in your blood turn it acidic. People who drink a lot of alcohol for a long time and don't eat enough also build up ketones. It can happen when you aren't eating at all, too. Lactic acidosis. The cells in your body make lactic acid when they don't have a lot of oxygen to use. This acid can build up, too. It might happen when you're exercising intensely. Big drops in blood pressure, heart failure, cardiac arrest, and an overwhelming infection can also cause it. Renal tubular acidosis. Healthy kidneys take acids out of your blood and get rid of them in your pee. Kidney diseases as well as some immune system and genetic disorders can damage kidneys so they leave too much acid in your blood. Hyperchloremic acidosis. Severe diarrhea, laxative abuse, and kidney problems can cause lower levels of bicarbonate, the base that helps neutralize acids in blood. Respiratory acidosis also results in blood that's too acidic. But it starts in a different way, when your body has too much carbon dioxide because of a problem with your lungs. Continue reading >>
Acidosis: The Kiss Of Death!
WHAT CAUSES A CONDITION CALLED "ACIDOSIS"? WHAT IS ACIDOSIS? Acidosis Definition: Acidosis is an increased acidity in the blood and other body tissue. Acidosis is said to occur when arterial pH falls below 7.35. The pH level of our blood affects every cell in our body. Chronic acidosis corrodes body tissue, and if left unchecked, will interrupt all cellular activities and functions. WHAT CAUSES ACIDOSIS? HIGH ACID-FORMING FOODS and DIETS all lead to ACIDOSIS. Living a fast-paced daily lifestyle, such as eating on the run and excessive over stimulation, will lead people to face a constant symptoms of indigestion and growing endangerment of over-acidification (Acidosis) of the body cells, which will interrupt cellular activities and functions. It is a major root of sickness and disease. Having our cells constantly exposed to an acidic environment leads to acidosis and then chronic acidosis and finally various forms of disease such as cancer and many more! Studies have shown that an acidic, anaerobic (which is also the lack of oxygen) body environment encourages the breeding of fungus, mold, bacteria, and viruses. As a result, our inner biological terrain shifts from a healthy oxygenated, alkaline environment to an unhealthy acidic one (acidic pH scale). This forces the body to constantly deplete its cellular energy to neutralize and detoxify these acids before they can act as poisons in and around the cells, ultimately changing the environment of each cell and finally compromising its immune system leaving it vulnerable to the ravages of disease to take a foothold in the body. When our body pH becomes overly acidic, it starts to set up defense mechanisms to keep the damaging acids from entering the vital organs. Modern Day Athletes and Acid-Forming Foods Unfortunately, Mo Continue reading >>