acid base terminology - mount sinai health system...pulmonary module slide 3-2 ©aacn 2001 normal...
TRANSCRIPT
Pulmonary Module ©AACN 2001Slide 3-1
Acid Base Terminology
Pulmonary Module ©AACN 2001Slide 3-2
Normal Arterial Blood Gas Values*
Pulmonary Module ©AACN 2001Slide 3-3
Acidemia vs Alkalemia
Pulmonary Module ©AACN 2001Slide 3-4
Buffers
Pulmonary Module ©AACN 2001Slide 3-5
Respiratory System
Pulmonary Module ©AACN 2001Slide 3-6
Renal System
To compensate or correct
To compensate or correct
Pulmonary Module ©AACN 2001Slide 3-7
Tubular Control of H+ by the Bicarbonate-Carbonic AcidSystem
Pulmonary Module ©AACN 2001Slide 3-8
Tubular Control of H+ by Phosphate
Pulmonary Module ©AACN 2001Slide 3-9
Tubular Control of H+ by Ammonia
Pulmonary Module ©AACN 2001Slide 3-10
Correction vs Compensation
Pulmonary Module ©AACN 2001Slide 3-11
Steps to Acid Base Interpretation
Pulmonary Module ©AACN 2001Slide 3-12
Practice Acid Base Interpretation
Pulmonary Module ©AACN 2001Slide 3-13
Compensation
7.37
7.42
Pulmonary Module ©AACN 2001Slide 3-14
Practice Acid Base Interpretation (Compensation)
7.46
7.34
Pulmonary Module ©AACN 2001Slide 3-15
Combined Disorders
Pulmonary Module ©AACN 2001Slide 3-16
Respiratory Acidosis
Pulmonary Module ©AACN 2001Slide 3-17
Respiratory Alkalosis
Pulmonary Module ©AACN 2001Slide 3-18
Metabolic Acidosis
pH < 7.35
PaCO2 normal (rarely) or decreased
HCO3- < 22 meq/l.
Pulmonary Module ©AACN 2001Slide 3-19
Anion Gap
--
Pulmonary Module ©AACN 2001Slide 3-20
Metabolic Alkalosis
normal (rarely) or increased
Pulmonary Module ©AACN 2001Slide 3-21
Arterial and Mixed Venous Gases
Pulmonary Module ©AACN 2001Slide 3-22
Oxyhemoglobin Dissociation Curve
Pulmonary Module ©AACN 2001Slide 3-23
Oxyhemoglobin Dissociation Curve: Causes of Shifts
Pulmonary Module ©AACN 2001Slide 3-24
Factors Leading to Tissue Hypoxia
Low cardiac output
Decreased oxygen carrying capacity
Non-functional hemoglobin
Right to left cardiac shunt
Impaired respiration
Pulmonary Module ©AACN 2001Slide 3-25
Body’s Compensation for Tissue Hypoxia
Tachycardia
Tachypnea
Erythrocytosis
Further desaturation of hemoglobin