ACID-BASE: REVIEW QUESTIONS

1. Interpret the following arterial blood gases:

A. pH = 7.35 PaCo2 = 50 HCO3 = 30 Compensated Respiratory

Acidosis

B. pH = 7.35 PaCO2 = 30 HCO3 = 20 Compensated Metabolic

Acidosis

C. pH = 7.45 PaCO2 = 50 HCO3 = 30 Compensated Metabolic

Alkalosis

D. pH = 7.45 PaCO2 = 30 HCO3 = 20 Compensated Respiratory

Alkalosis

E. pH = 7.32 PaCO2 = 32 HCO3 = 15 Metabolic Acidosis

F. pH = 7.30 PaCO2 = 50 HCO3 = 33 Respiratory Acidosis

G. pH = 7.48 PaCO2 = 33 HCO3 = 24 Respiratory Alkalosis

H. pH = 7.5 PaCO2 = 48 HCO3 = 34 Metabolic Alkalosis

2. What will a person try to do to compensate for a metabolic acidosis?

A. They will hyperventilate (increase their respiratory rate) in an

effort to blow off CO2 and correct the pH imbalance.

3. What acid-base imbalance occurs with:

A. Chronic renal failure: metabolic acidosis

B. Over sedation: respiratory acidosis
C. Diabetic Ketoacidosis: Metabolic acidosis (Kussmal’s
respirations attempt to correct)
D. Fear: respiratory alkalosis (d/t hyperventilation)
E. Excessive ingestion of antacids: metabolic alkalosis
 4. What do hydrogen ions and carbon dioxide make: acids. The more
hydrogen ions or carbon dioxide you have the more acidic you are.

5. What venous lab test is the same as an arterial bicarbonate level?

A. A venous CO2 level which is part of a chemistry profile.

6. How do lactic acidosis and Ketoacidosis occur?

A. Lactic acidosis occurs d/t anaerobic metabolism (metabolism

without oxygen) of glucose (i.e. Cardiopulmonary arrest,
arterial occlusion, severe shock). Ketoacidosis occurs d/t
utilization of fats instead of carbohydrates (glucose) for energy
(i.e. Diabetic Ketoacidosis).

7. Explain the difference between an uncompensated, partially

compensated and compensated acid base imbalance.

A. When a problem originally happens, it is uncompensated. For

example: A COPD patient retains CO2 and develops a respiratory acidosis:

pH = 7.32 PaCO2 = 48 HCO3 = 24. Only the pH & paCO2 are abnormal.

The kidneys will begin to excrete H+ and hold onto bicarb in an attempt to
compensate causing a partially compensated ABG:

pH = 7.34, PaCO2 = 48, HCO3 = 28 All are abnormal

Eventually the kidneys will be successful in holding on to the “right”

amount of bicarb = compensated ABGs:

pH = 7.36, PaCO2 = 48, HCO3 = 32 pH is normal, PaCO2 & HCO3 are

abnormal.

How do I know which one caused the problem? The body will not
overcorrect the acid-base imbalance, which means the pH will be closest to
the problem. A pH of 7.36 is closest to acidosis, right? So, to create an
acidosis, you need either more acid (CO2) than usual or less base (HCO3)
than usual. The ABGs above have more acid and more base. Only more
acid can cause an acidosis. So this is a compensated respiratory acidosis.