Acid Base Balance - Chemeketa Faculty：酸碱平衡Chemeketa学院.pptVIP

So in the lungs? Oxygen has an affinity to hemoglobin and it climbs on board kicking off the CO2 The CO2 and water are displaced and through osmosis and diffusion are blown out with expiration of air. Gee Whiz! After the CO2 has been blown away in the lungs…what happens? Exactly! The pH increases, bringing the body back to normal. Renal System If the lungs and buffers are not able to keep up with the amount of acids, then the kidneys must take action. It may take the kidneys hours or days to react to an imbalance. What do the kidneys do to help? They regulate pH by expelling excess hydrogen or bicarbonate ions. The kidney tubules are smart. When they expel one ion they will exchange it for another. Kidneys work OT with COPD When someone chronically retains CO2 the kidneys become the primary balancing system. Example is the chronic emphysema patient. They rely entirely on the renal system to maintain pH. More Values Base Excess BE = +or- 6 Bicarb HCO3 = 22-26mEq/L Acid-Base Derangements Respiratory: Acidosis Alkalosis Metabolic: Acidosis Alkalosis Respiratory Acidosis Hypoventilation Retained CO2 pH decreases Causes: Trauma, illness, medications. You guys can treat this! Causes of Respiratory Acidosis Lungs – COPD, Pneumonia, ARDS Airway obstruction – Mucous plug, atelectasis, FBAO Respiratory depression – anesthesia, OD, trauma Inadequate lung expansion – skeletal trauma, pneumothorax, ascites S/S for Respiratory Acidosis H/A (cerebral vasodilation) Tachycardia (hypercapnia) Bradycardia (incr. K+) Cardiac arrhythmias (hyperkalemia) Decreased CNS – confusion to coma Neuromuscular weakness - hyporeflexia, flaccid paralysis Treatment for Respiratory Acidosis Adequate hydration Bronchodilators OXYGEN Respiratory Alkalosis Hyperventilation Pain, anxiety Blows off CO2 pH Increase O2 or Rebreathe CO2??? Causes of Respiratory Alkalosis Anxiety, pain, or hypoxia due to epi release Febrile ASA OD Brain trauma/tumor Septic shock (early) S/S of Respiratory