ACID BASE BALANCE HOMEOSTASIS Relative of hydrogen ions

ACID – BASE BALANCE HOMEOSTASIS Relative [ ] of hydrogen ions p. H – potential hydrogen Normal p. H: 7. 35 – 7. 45 <7. 35 is acidosis >7. 45 is alkalosis

Deviation of 0. 4 in either direction can be fatal

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…. .

Wood alcohol Antifreeze Large doses of ASA Abnormal metabolism Advanced stages of shock Poorly controlled IDDM Normal levels of acid if kidneys aren’t functioning normally

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

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

RESPIRATORY ACIDOSIS Build up of CO 2 in the blood from poor lung function or slow breathing Blood becomes acidic -> p. H drops respiratory center in the brain stimulates faster and deeper breathing Develops when…….

Develops when the lungs do not expel CO 2 adequately…. such as Emphysema Chronic bronchitis Severe pneumonia Pulmonary edema Asthma

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

First symptom may be headache and drowsiness Drowsiness may progress to stupor or coma ABGs Treatment…. .

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; HCO 3 - (provides only temporary relief and may cause harm by overloading the body with Na+ and H 2 O

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

J: Class PresentationsBA Acid Base Disturbances. doc

Life essential functions like K+ and Na+ channels are inactivated by acidosis A habitually acid p. H 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

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

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

Respiratory Alkalosis Low levels of CO 2 in the blood that results from rapid or deep breathing Hyperventilation anxiety cirrhosis low levels of oxygen in the blood fever ASA overdose

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 kidney’s ability to control the blood’s acid-base balance loss of K+ - use of diuretics or corticosteroids

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

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)

Treatment Metabolic Replacing H 2 O, Na+, and K+ while treating underlying cause Next: …………. .

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

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

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

Water is essential for high rates of metabolism necessary to promote growth With age Loss of muscle mass inc. % of fat Body’s 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

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

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

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

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

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

ANIONS Cl. Plays a major role in fluid balance and renal function HCO 3 Principal buffer

Phosphate HPO 4 Body energy stores Closely associated with Mg++ in renal function Acts as a buffer primarily in the intracellular space

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

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

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

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

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

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

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

HYPOTONIC Lower solute [ ] than the cells Movement extracellular intracellular

ABGs Determine p. H but also to differentiate respiratory / metabolic acidosis / alkalosis Norms p. H 7. 35 - 7. 45 Pa. CO 2 35 - 45 Pa. O 2 greater than 80 HCO 322 - 28

Pa. CO 2 Amount of CO 2 dissolved in arterial blood Pa. O 2 amount of oxygen dissolved in arterial blood HCO 3 amount of bicarbonate

Interpretation (R)espirtory (O)pposite, (M)etabolic (E)qual If the p. H is opposite the Pa. CO 2 (high or low) then it’s respiratory if the p. H is equal to the HCO 3, it is metabolic