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91 Cards in this Set
- Front
- Back
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fluid loss from the skin and lungs is called
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insensible loss
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fluid losses from urination, deification, wounds, or other means is called
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sensible
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what % bodyweight of a full term neonate is H2O
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80% H2O
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what % bodyweight of a premature infant is H2O
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90% H2O
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does the % body weight go up or down with age
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down until puberty
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in a lean 154lb (70kg) male what is the % H2O
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60% H2O
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What is plasma colloid osmotic pressure and what is it's avj
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albumin within a vessel which acts on the H2O
avj pressure is 25mmHg |
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a urine excretion rate less than ____ ml/hr indicates renal disease
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20 ml/hr
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antidiuretic hormone (ADH) (vasopressin) is produced ______ and the ______ releases it
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produced in the hypothalmus and stored and released by the posterior pituitary gland
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what does ADH do (end effect)
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causes the kidneys to reabsorb more H2O
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juxtaglomearular cells secrete
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renin
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renin is converted to ____ a powerful vasoconstrictor
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angiotensin II
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the production of angiotensin II leads to
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stimulats the adrenal glands to produce aldesterone
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steps of aldosterone production
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1)blood flow to the glomerulus drops
2)juxtaglomerular cells secrete renin to B.S. 3)renin travels to the liver 4)in the liver renin converts angiotensinogen to angiotension I 5)angiotensin I travels to the lungss 6)in the lungs angiotensin I converts to angiotensin II 7)angiotensin II travels to adrenal gland 8)angiotensin II stimulates adrenal gland to produce aldosterone |
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what causes the active transport of sodium from the distal tubules and the collecting ducts into the B.S. and what is its net effect
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aldosterone causes the blood volume to expand
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atrial natriuretic peptide is produced ___ and is released ___ causing the intravascular volume to ___
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cardiac hormone
counters the act of the renin-angiotensin-aldosterone system y decreasing blood pressure and reducing intravascular blood volume |
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anything that increases atrial stretching can also lead to an increase of
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atrial natriuretic peptide (ANP)
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what do these pairs of ions have in common
Na+ -----Cl- Ca+ -----P- |
these ions are so closely related that an imbalance in one leads to an imbalance in the other
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3 common anions
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bicarbonate, chloride and phosphorus
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4 common cations
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calcium, magnesium, potassium and sodium
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major electrolytes OUTSIDE the cell
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sodium, chloride, calcium, bicarbonate
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what roll does calcium play outside the cell
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-stabilize the cell membrane & decreases permeability to sodium
-transmits nerve impulses -contracts muscles -coagulates blood -helps form bone and teeth |
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major electrolytes INSIDE the cell
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potassium, phosphate, magnesium
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potassium plays a major roll in
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-cell excitability regulation
-nerve impulse conduction -resting membrane potential -muscle contraction & myocardial membrane responsiveness -intracellular osmolarity control |
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what roll does phosphorus play
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-energy metabolism
-helps maintain the acid-base balance |
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what roll does magnesium play
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-acts as an catalyst for enzyme reactions
-regulates neuromuscular contraction -promotes normal functioning of both nervous & cardiovascular system -aids in protein synthesis -aids in sodium + potassium ion transportation |
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range for serum sodium normal
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135 - 145 mEq/L normal
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hyponatremia
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<135 mEq/L sodium common cause
syndrome of inappropriate antidiuretic hormone secretion |
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hypernatemia
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>145 mEq/L sodium
common cause diabetes insipidus |
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range for serum potassium
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3.5 - 5 mEq/L normal
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hypokalemia
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<3.5 mEq/L potassium
common cause diarrhea |
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hyperkalemia
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>5 mEq/L potassium
common cause burns or renal failure |
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rage for total serum calcium normal
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8.9 - 10.1 mg/dL normal
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hypocalcemia
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<4.4mg/dL
common cause acute pancreatitis |
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hypercalcemia
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>10.1 mg/dL
common cause hyperparathyrodism |
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normal range for ionized calcium
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4.4 to 5.3mg/dL
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hypocalcemia
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<4.4mg/dL ionized calcium
common cause massive transfusion |
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hypercalcemia
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>5.3 mg/dL ionized calcium
common cause acidosis |
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normal range for serum phosphates
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2.5 to 4.5 mg/dL or
1.8 to 2.6m Eq/L normal |
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hypophosphatemia
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<2.5mg/dL or 1.8mEq/L serum phosphates
common cause diabetic ketoacidosis |
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hyperphosphatemia
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>4.5mg/dL or 2.6nEq/L serum phosphates
common cause renal insuffiniency |
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normal range for serum magnesium
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1.5 to 2.5 mEq/L
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hypomagnesemia
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<1.5 mEq/L serum magnesium common cause
malnutrition |
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hypermagnesemia
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>2.5 mEq/L serum magnesium
common cause renal failure |
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normal range for serum chloride
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96 to 106 mEq/L normal
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hypochloremia
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<96 mEq/L serum chloride
common cause prolonged vomiting |
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hyperchloremia
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>106mEq/L serum chloride
common cause hypernatemia |
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parathyroid glands play a roll in
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the balance of calcium and phosphorus
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the parathyroid glands can draw calcium and phosphorus from____ to excrete through the kidneys
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blood, bones, intestines and kidneys
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to affect electrolyte balance the thyroid gland cans excrete
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calcitonin
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when a burn damages cells you would expect them to release the electrolyte
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potassium which can cause hperkalemia
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diuretics affect the kidneys by altering the reabsorption and excretion of
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water and electrolytes
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the main extracellular cation is
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sodium
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in the nephron most electrolytes are reabsorbed in the
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proximal tubule
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potassium is essential for conducting electrical for conducting electrical impulses because it causes ions to
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shift ions in and out of the cell which allows electrical impulses to be conducted from cell to cell
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older adults are at increased risk for electrolyte imbalances because with age the kidneys have
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fewer functioning nephrons
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where is blood normally drawn from to measure pH
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arterial blood
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normal blood pH is (numbers)
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7.35 to 7.45
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normal blood pH is (acidic or alkaline)
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slightly alkaline
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acidosis
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a pH below 7.35
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alkalosis
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a pH above 7.45
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3 types of pH regulatory factors
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-chemical buffers
-respiratory system -kidneys |
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3 main chemical buffers
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bicarbonate, phosphate,and protein
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bodies primary buffer system
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bicarbonate
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the bicarbonate system is mainly responsible for
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blood and interstitial fluid
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what organ regulates the production of bicarbonate
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kidneys
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what organ regulates the production of carbonic acid
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lungs (amount of CO binding with H2O)
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the phosphate buffer system is especially effective in the
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renal tubules where they are in higher concentrations
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the most plentiful buffers in the body
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protein buffers
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hemoglobin is a type of _____ buffer
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protein buffer
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________ sense pH changes and vary the rate and depth of breathing to compensate for changes in pH
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chemorceptors in the medulla
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as carbon dioxide is lost less carbonic acid is made and pH
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rises
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normal PaCO2
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35 to 45mm Hg
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how do the kidneys affect overall pH
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reabsorbtion or excretion of acids or bases
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how long does it take the kidneys to effect pH
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hours or days but lasts long term
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how long does it take the lungs to effect pH
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minutes but only is temporary
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normal amount of bicarbonate in an ABG
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22 to 26 mEq/L
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normal ABG pH
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7.35 to 7.45
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normal ABG PaCO2
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35 to 45 mm Hg
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normal ABG HCO3
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22 to 26 mEq/L
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step 1 interpreting ABG
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Check the pH 7.35 to 7.45
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step 2 interpreting ABG
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determine the CO2 35 to 45 mm Hg
if pH is high you would expect PaCO2 to be low hypocapnia if pH is low you would expect PaCO2 to be high hypercapnia |
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step 3 interpreting ABG
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Watch the bicarbonate
high expect high bicarbonate (metabolic alkalosis) low expect low bicarbonate (metabolic acidosis) |
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step 4 interpreting ABG
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look for compensation
this involves opposite shifts and shows compensation |
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step 5 interpreting ABG
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determine Pao2 and SaO2
this shows the ability of the pt to pick up oxygen from the lungs |
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PaCO2 level indicates the effectiveness of
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respiratory system ability to help maintain acid-base balance
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the kidneys respond to acid-base balance disturbances by
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excreting or reabsorbing hydrogen or bicarbonate according to the bodies needs
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if your pt is breathing rapidly this body is attempting to
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get rid of carbon dioxide
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if your pt has higher than normal pH (alkalosis) you you would expect to also see
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low PaCO2 and high HCO3
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in the following ABG
pH 7.33 PaCO2 40 mm Hg HCO3 20 mEq/L |
the pH is low (acidosis)
PaCO2 is normal Bicarb is low (matches the pH) metabolic acidosis |
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in the following ABG
pH 7.52 PaCo2 47 mmHg HCO3 36 mEq/L |
pH is alkalotic and both PaCO2 and HCO3 have changed the HCO3 matches the pH elevated PaCO2 represents efforts of the respiratory system to compensate
Metabolic acidosis with respiratory compensation |
