Acid Base Balance

Acid Base Balance:

Hydrogen is an acid

pH = Hydrogen ion concentration, the balance of acid produced and acid eliminated

The higher the amount of H, the lower the pH; the lower the amount of H the higher the pH

Normal blood pH is 7.35-7.45

Maintain pH with 3 systems:

  • Buffers = chemical sponges. Bicarbonate (HCO3)/carbonic acid (H2 CO3) balance (better with acidosis)
  • Lungs – regulate the CO2 and H2 CO3 in the body
  • Kidneys – excrete H and HCO3 as indicated by the pH of the blood. Deals with Alkalosis or Acidosis equally well but takes 10-12 hours.


Respiratory Acidosis:

Breathing too low, too much CO2, too much Carbonic Acid (H2 CO3), low pH S&S:

  • Hypoventilation
  • Shallow respirations
  • Disorientation
  • Stupor

Respiratory Alkalosis:

Breathing too high, too little CO2, too little Carbonic Acid, High pH S&S:

  • Hyperventilation
  • Numbness, tingling
  • Mental Restlessness
  • Agitation, hysterical
  • Unresponsiveness

Metabolic Acidosis:

Too much H, too much Carbonic Acid (H2 CO3), low Bicarbonate (HCO3), low pH S&S:

  • Starvation
  • Renal impairment
  • Diabetes (diabetic ketoacidocis)
  • Prolonged diarrhea
  • Kussmaul breathing
  • Weakness
  • Disorientation
  • Coma

Metabolic Alkalosis:

Too little H, low Carbonic Acid (H2 CO3), high Bicarbonate (HCO3), High pH S&S:

  • Excess baking soda
  • Prolonged vomiting
  • Slow shallow respirations
  • Muscular tension
  • Tetany (extremity spasms)
  • Mental Dullness

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