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When are acids produced?
acids are produced during metabolism
What is the purpose of bases?
bases neutralize and promote the excretion of acids
What health problems affect acid base balance?
diabetes mellitus

COPD

Kidney disease
how do acids affect pH?

How do bases affect pH?
acids lower pH

Bases raise pH
What is the metabolic parameter for acid/bases
HCO3-bicarbonate, which is a base
What is respiratory parameter for acid/bases
pCO2- carbon dioxide, which is an Acid
What is metabolic acidosis?
Increase in noncarbonic acid or loss of bicarbonate
What causes metabolic acidosis?
lactic acidosis,
ketoacidosis
ingestion of acidic substances
renal disease
loss of bicarbonate or reduced H+ excretion
What are signs and symptoms of metabolic acidosis
nIncreased respiratory rate & depth: Kussmaul respirations nHA, lethergy leads to coma nN&V, diarrhea, abdominal pain nElevated serum K+ (shift of K+ out of cell, H+ into cell) 
What happens to the lab levels in metabolic acidosis
pH drops

pCO2 normal to below 35

Bicarb: below 22
What is metabolic alkalosis

nExcessive loss of metabolic acids (not carbonic) retention of bicarbonate, or excessive ingestion alkalizing agents
What causes metabolic alkalosis
Vomiting, NG drainage (loss of acid)
Diuretics
Excessive ingestion of antacids or IV bicarb
Hyperaldosterone (steroids) loss of chloride retention of bicarb
what are the signs and symptoms of metabolic alkalosis
nWeakness, muscle cramps, hyperactive reflexes, dysrythmia (hypokalemia) nDecreased respiratory depth and rate (leads to elevated pCo2 levels) nConfusion, seizure
What happens to the lab levels in metabolic alkalosis
pH increase above 7.45

paCO2 is normal to above 45

Bicarb is greater than 26
What is respiratory acidosis

nAn increase in carbonic acid / retention of carbon dioxide (pCo2)
What causes respiratory acidosis
Respiratory depression, drugs, head injury
Respiratory muscle paralysis
Disorders of the lung tissue (COPD, pneumonia)
Pulmonary embolism, pulmonary edema
What are the signs and symptoms of respiratory acidosis
nSOB, restlessness nLethargy, disorientation, seizure, coma nWarm flushed skin (vasodilation from increased CO2 levels)
What happens to lab levels in respiratory acidosis
pH drops below 7.35

pCO2 increases above 45

Bicarb is normal to above 26
What is respiratory alkalosis

nExcessive respiratory rate and depth, reduction in carbon dioxide levels
What causes respiratory alkalosis
nHyperventilation (hysteria, mechanical ventilation) nHypoxemia in pulmonary disease or CHF nHypermetabolic states (fever, anemia, thyroid storm)
What are the signs and symptoms of respiratory alkalosis
nDizziness confusion ( cerebral vasoconstriction) nParesthesias, carpopedal spasm, (hypocalcemia) nRapid deep respirations
What happens to lab values in Respiratory alkalosis
pH increases above 7.45

pCO2 decreases below 35

bicarb is normal to below 22
How does the body compensate for metabolic acidosis?

nMetabolic acidosis: respiratory rate increases to blow off Co2 (decrease acid)
How does the body compensate for respiratory acidosis
kidneys increase H+ excretion and bicarb reabsorption (increase base)
How does the body compensate for metabolic alkalosis

respiratory rate decreases to retain Co2 ( increase acid)
How does the body compensate for respiratory alkalosis?

kidneys decrease H+ excretion and bicarb reabsorption (decrease base)
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