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ACID – BASE BALANCE HOMEOSTASIS Relative [ ] of hydrogen ions pH – potential hydrogen Normal pH: 7.35 – 7.45 <7.35 is acidosis >7.45 is alkalosis.

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Presentation on theme: "ACID – BASE BALANCE HOMEOSTASIS Relative [ ] of hydrogen ions pH – potential hydrogen Normal pH: 7.35 – 7.45 <7.35 is acidosis >7.45 is alkalosis."— Presentation transcript:


2 ACID – BASE BALANCE HOMEOSTASIS Relative [ ] of hydrogen ions pH – potential hydrogen Normal pH: 7.35 – 7.45 <7.35 is acidosis >7.45 is alkalosis

3 Deviation of 0.4 in either direction can be fatal

4 ACIDOSIS Metabolic Acidosis Excessive blood acidity or loss of bicarbonate Causes ingestion of something that is or can be metabolized to an acid such as…..

5 Wood alcohol Antifreeze Large doses of ASA Abnormal metabolism Advanced stages of shock Poorly controlled IDDM Normal levels of acid if kidneys arent functioning normally

6 Symptoms Mild metabolic acidosis may have no sx. Usually experiences nauseavomitingfatigue Breathing becomes deeper and slightly faster As acidosis worsens:

7 Extremely weak and drowsy May feel confused Increasingly nauseated Eventually b/p can fall leading to shock, coma, or death Treatment: Depends primarily on the cause insulin removing toxic substances

8 RESPIRATORY ACIDOSIS Build up of CO2 in the blood from poor lung function or slow breathing Blood becomes acidic -> pH drops respiratory center in the brain stimulates faster and deeper breathing Develops when…….

9 Develops when the lungs do not expel CO2 adequately….such as Emphysema Chronic bronchitis Severe pneumonia Pulmonary edema Asthma

10 Diseases of the nerves or muscles of the chest If overly sedated from narcotics and strong sleeping medications that slow respirations Symptoms:

11 First symptom may be headache and drowsiness Drowsiness may progress to stupor or coma ABGsTreatment…..

12 Aims at improving function of the lungs i.e. drugs to improve breathing If acidosis is mild, IV fluid may be all that is needed If severe; HCO3- (provides only temporary relief and may cause harm by overloading the body with Na+ and H2O

13 Treatment Slow down rate Pain relief Other facts to ponder………….

14 J:\Class Presentations\BA Acid Base Disturbances.doc J:\Class Presentations\BA Acid Base Disturbances.doc

15 Life essential functions like K+ and Na+ channels are inactivated by acidosis A habitually acid pH can directly cause immediate weight gain Fasting and dieting are known acid producing conditions One way the body compensates is to deposit excess acid into tissues and joints

16 Acid producing foods create excess mucus, which congests the system and block oxygen from entering

17 ALKALOSIS Overabundance of bicarbonate in the blood Loss of acid from the blood

18 Respiratory Alkalosis Low levels of CO2 in the blood that results from rapid or deep breathing Hyperventilationanxietycirrhosis low levels of oxygen in the blood fever ASA overdose

19 METABOLIC ACIDOSIS Body looses too much acids Gain too much base stomach acid is lost during periods of prolonged vomiting excessive loss of Na+ or K+ affects the kidneys ability to control the bloods acid-base balance loss of K+ - use of diuretics or corticosteroids

20 Corticosteroids Steroid hormones Synthesized from cholesterol Involved in stress response, immune response, regulation of inflammation, carbohydrate metabolism, protein catabolises blood electrolyte level and behavior

21 Catabolism: breaks down molecules into smaller units and releases energy Alkalosis may cause: Irritability Muscle twitching Muscle cramps If severe, prolonged contraction and spasms of muscle (tetnaory)

22 TreatmentMetabolic Replacing H2O, Na+, and K+ while treating underlying cause Next: …………..

23 FLUIDS AND ELECTROLYTYES Water 60% total body weight Distributed into various compartments, separated by cell membranes Largest compartment is intracellular environment ICF All the fluid found inside body cells 75% of all water is found within this compartment

24 Extracellular compartment 2 divisions Intravascular fluid Outside the cells and within the circulatory system. Essentially the same as the blood plasma

25 Interstitial fluid Outside the cell membranes, not within the circulatory system TBW Infants – 75-80% Infants have less fat. Fat does not absorb water. Less fat, more water

26 Water is essential for high rates of metabolism necessary to promote growth With age Loss of muscle mass inc. % of fat Bodys decreasing ability to regulate fluid levels lower TBW to 45-55% Elderly and very young are at high risk for dehydration and disorders related to to electrolyte imbalances

27 ELECTROLYTES Dissociate in electronically charged particles when placed into water ions Cations+ charge Anions- charge

28 CationsNa+ Most prevalent in extracellular fluid Plays major role in distribution of water Important in the transmission of nervous impulses

29 K+ Intracellular fluid Transmission of electrical impulses Ca++ Major role in muscle contraction Nervous impulse transmission

30 Mg++ Necessary for several biochemical processes (over 300) Prevents over excitability of muscles ½ found in bone ½ found predominantly inside cells of tissues and organs Helps maintain normal nerve and muscle function

31 Regulates heart rhythm Supports healthy immune system Keeps bones strong Helps regulate blood sugar levels Promotes normal blood pressure Known to be involved in protein synthesis and metabolism

32 ANIONSCl- Plays a major role in fluid balance and renal function HCO3- Principal buffer

33 PhosphateHPO4- Body energy stores Closely associated with Mg++ in renal function Acts as a buffer primarily in the intracellular space

34 OSMOSIS AND DIFFUSION Isotonic When solutions on opposite sides of a semipermiable membrane are equal in [ ] > on one side – hypertonic < on one side – hypotonic Difference in [ ] – osmotic gradient

35 Homeostasis The tendency to keep the balance of water electrolytes are = on both sides of the membrane. Diffusion Movement from an area of higher [ ] to lower [ ] and does not require energy

36 Osmosis The passage of any solvent usually water through a membrane Active Transport Movement of a substance across the cell membrane against the osmotic gradient or toward the side that already has more of the substance; requires an expenditure of energy

37 Facilitated diffusion Diffusion of a substance such as glucose that requires the assistance of a helper or carrier protein

38 FLUIDS COLLOIDS Contain large proteins Cannot pass through a capillary membrane Remains in the circulatory system Increases volume of blood and fluid contained within the blood vessels

39 CRYSTALLOID Contain electrolytes and water Tonicity: number of particles per unit volume Isotonic Tonicity equal to blood plasma Will not cause a significant fluid or electrolyte shift

40 HYPERTONIC Higher solute [ ] that the cells Causes fluid shift out of intracellular compartment into extracellualar compartment

41 HYPOTONIC Lower solute [ ] than the cells Movement extracellular intracellular

42 ABGs Determine pH but also to differentiate respiratory / metabolic acidosis / alkalosis Norms pH PaCO PaO2greater than 80 HCO

43 PaCO2 Amount of CO2 dissolved in arterial blood PaO2 amount of oxygen dissolved in arterial blood HCO3 amount of bicarbonate

44 Interpretation (R)espirtory (O)pposite, (M)etabolic (E)qual If the pH is opposite the PaCO2 (high or low) then its respiratory if the pH is equal to the HCO3, it is metabolic

45 Problem #1 pH7.30 PaCO250 HCO326 PaO260 Acidosis or Alkalosis? Metabolic or Respiratory? Answer………

46 Respiratory Acidosis Why? pH is high indicating Acidosis pH is low; PaCO2 is high {opposite} indicating this is respiratory Problem #2

47 pH7.50 PaCO243 HCO345 PaO280 Acidosis or Alkalosis? Metabolic or Respiratory? Answer………

48 Metabolic Alkalosis Why? pH is high indicating alkalosis pH high; HCO3- high {equal} Indicating this is metabolic METABOLIC ACIDOSIS

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