OnlineMedEd Shared "Acid Base 2" - 20 Picmonics
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Acid Base 2
Respiratory Alkalosis
- Hyperventilation
- High Altitude
- Aspirin
- Restrictive Lung Disease
- Pulmonary Embolism
- Pregnancy
- Progesterone
- Rib Fracture
- Anxiety
2 mins
Respiratory Alkalosis Interventions
- Treat Underlying Cause
- Mechanically Ventilated Patients
- Decrease Tidal Volume and/or Respiratory Rate
- Give Adequate Pain Control and Sedation
- Hyperventilation Syndrome
- Rebreathing into Paper Bag
- Sedatives
- Antidepressants
- Considerations
- Compensatory Drop in Serum Bicarbonate
- Correct CO2 Slowly
2 mins
Respiratory Acidosis
- Hypoventilation
- Increased PaCO2 > 45
- Barbiturates Depress Central Respiratory Center of Brain
- Opioids Depress Central Respiratory Center of the Brain
- Airway Obstruction
- Respiratory Muscle Weakness/Paralysis
3 mins
Respiratory Acidosis Interventions
- Improve Respiration
- Pharmacologic Interventions
- Bronchodilators
- Respiratory Stimulants
- Drug Antagonists
- Nonpharmacologic Interventions
- Oxygen
- Assisted Ventilation
- Prevent Complications
1 min
Metabolic Alkalosis
- Diuretic use
- Vomiting
- Antacid
- Hyperaldosteronism
26 secs
Metabolic Alkalosis Interventions
- Interventions
- Treat Underlying Cause
- Stop Potassium (K+) Wasting Diuretics
- Spironolactone
- Acetazolamide
- IV Fluids
- Sodium Chloride
- Replace Potassium (K+)
- Considerations
- Monitor Respiratory Rate
- Monitor Heart Rate
- Seizure Precautions
2 mins
Normal Gap Metabolic Acidosis
- HARD-ASS
- Hyperalimentation
- Addison's Disease
- Renal Tubular Acidosis
- Diarrhea
- Acetazolamide
- Spironolactone
- Saline Infusion
2 mins
Anion Gap Metabolic Acidosis
- Pathophysiology
- Increased Anion Gap
- MUDPILES
- Methanol
- Uremia
- Diabetic Ketoacidosis (DKA)
- Propylene Glycol
- Isoniazid or Iron
- Lactic Acid
- Ethylene Glycol
- Salicylates
1 min
Metabolic Acidosis Interventions
- Interventions
- Raise Plasma pH > 7.20
- Treat Underlying Cause
- Sodium Bicarbonate
- Considerations
- Follow ABGs
- Continuously Monitor Patient
2 mins
How to Interpret Acid Base Disorders
- pH, pCO2, HCO3 (Bicarbonate)
- Step 1
- pH
- Acidosis
- Alkalosis
- Step 2
- pCO2
- Opposite Direction As pH
- Respiratory Acidosis
- Respiratory Alkalosis
- Step 3
- HCO3 (Bicarbonate)
- Same Direction As pH
- Metabolic Acidosis
- Metabolic Alkalosis
3 mins
Respiratory Acidosis Assessment
- Assessment
- Decreased pH < 7.35
- Increased PaCO2 > 45
- Reduced Respirations
- Anxiety
- Change in LOC
- Tachycardia
- Cyanosis
- Increased Electrolytes
- ECG Changes
- Muscle Weakness
- Hyporeflexia
2 mins
Respiratory Alkalosis Assessment
- Assessment
- Increased pH > 7.45
- Decreased PaCO2 < 35 mmHg
- Hyperventilation
- Brainstem Stimulation
- Head Injury
- Shock
- Lightheadedness
- Tingling Lips or Fingers
- Trousseau's
- Chvostek's Sign
- Anxiety
2 mins
Metabolic Acidosis Assessment
- Characteristics
- Decreased pH < 7.35
- Decreased HCO3 < 22
- Signs & Symptoms
- Abdominal Pain
- CNS Depression
- Coma
- Hypotension
- Arrhythmias
- Increased Respirations
- Kussmaul Respirations
- Flushed, Warm, Dry Skin
- Muscle Weakness
2 mins
Metabolic Alkalosis Assessment
- Signs and Symptoms
- Increased pH > 7.45
- Increased HCO3 > 26
- Excitable State
- Arrhythmias
- Paresthesias
- Muscle Cramps
- Muscle Weakness
- Decreased Respiratory Effort
1 min
Type 2 Renal Tubular Acidosis
- Proximal Tubule
- Pathophysiology
- Inability To Reabsorb Bicarbonate
- ETIOLOGY
- Fanconi Syndrome
- Sporadic Type
- Familial Types
- Autosomal Recessive
- Acetazolamide
- Characteristics
- Decreased Urinary pH
- Hypokalemia
- Treatments
- Treat Underlying Disorder
- Alkali Therapy
4 mins
Renal Tubular Acidosis Type 4
- Characteristics
- Aldosterone Resistance
- Decreased Aldosterone Production
- Causes Of Hypoaldosteronism
- Addison’s Disease (Primary Adrenal Insufficiency)
- Hyporeninism
- Causes Of Aldosterone Resistance
- Trimethoprim-Sulfamethoxazole
- Potassium Sparing Diuretics
- Labs
- Hyperkalemia
- Low Urine pH
- Diminished Ammonium (NH4) Urinary Excretion
- Treatment
- Furosemide
- Fludrocortisone
5 mins
Distal Renal Tubular Acidosis (Type I)
- Pathophysiology
- Distal Tube
- Defect in H+ Secretion
- Labs
- Increased Urinary pH
- Urinary pH >5.5
- Hypokalemia
- Causes
- Amphotericin B Toxicity
- Autoimmune Disease
- Lithium
- Obstruction Of The Urinary Tract
- Complication
- Kidney Stones
- Treatment
- Bicarbonate
3 mins
Indications for Urgent Dialysis (AEIOU)
- Signs and Symptoms
- AEIOU Mnemonic
- Acidosis
- pH < 7.1
- Electrolyte Imbalances
- Symptomatic Hyperkalemia
- > 6.5 mEq/L
- Ingestion
- Overload (Volume)
- Uremia
- Encephalitis
- Pericarditis
2 mins
Addison's Disease
- Mechanism
- Chronic 1° Adrenal Insufficiency
- Atrophy
- Destruction
- Symptoms
- Deficiency In Cortisol And Aldosterone
- Skin Hyperpigmentation
- Increased POMC
- Hypotension
- Hyperkalemia
- Acidosis
- Addisonian Crisis
- Diagnosis
- ACTH (Cosyntropin) Stimulation Test
- Treatment
- Exogenous Cortisol
2 mins
Winter's Formula
- Evaluates Respiratory Compensation
- Used in Metabolic Acidosis
- Equation
- (HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
- Steps
- Bicarbonate (HCO3) x 1.5
- + 8
- ± 2
- = Expected Value for PCO2
2 mins
