...emergency department for management of acute mushroom poisoning. Her respirations are slow and shallow, and she is non-responsive. She is admitted to the critical care unit to be closely monitored for the development of ventilatory failure and renal failure, which often accompany mushroom poisoning. Her urine output is decreased at about 20 ml/hr. Her laboratory values are: * Serum K+ = 5.7 mEq/L * Arterial blood gases (ABGs) * pH = 7.13 * PaCO2 = 56 mm Hg * PaO2 = 89 mm Hg * HCO3– = 18 mEq/L. Questions 1. What is the relationship between acid-base balance and serum potassium level? 2. What is the reason for L.S.’s low urine output? How should her fluids be managed? 3. Categorize and explain the probable cause of L.S.’s acid-base disorder. 4. Can L.S. compensate for her acid-base disorder? Why or why not? 5. How should her acid-base imbalance be medically managed? 1. Acid-base balance can influence the serum K+ levels detected in the blood. When a patient experiences hypokalemia, K+ is excreted from the cells and H+ takes its place creating an alkalotic state; K+ is processed out of the body via the kidneys and polyuria can be a clinical symptom. In the case of hyperkalemia, K+ is not properly processed by the kidneys as a result of renal failure; decreased urine output is a clinical symptom. 2. The reason for the patient’s low urine output is due to her acute renal failure. Since the kidneys are in failure, they cannot properly...
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...Lewis: Medical-Surgical Nursing, 9th Edition Chapter 17 Fluid, Electrolyte, and Acid-Base Imbalances KEY POINTS HOMEOSTASIS · Body fluids and electrolytes play an important role in maintaining a stable internal environment of the body. · A number of adaptive responses keep the composition and volume of body fluids and electrolytes within the narrow limits of normal to maintain homeostasis and promote health. · Many diseases and their treatments have the ability to affect fluid and electrolyte balance and alter homeostasis. WATER CONTENT OF BODY · Water is the primary component of the body, accounting for approximately 60% of the body weight in the adult. · The two major fluid compartments in the body are intracellular fluid (ICF), or inside the cells, and extracellular fluid (ECF), or outside the cells. ECF is composed of interstitial fluid, plasma, and transcellular fluids. ELECTROLYTES · Electrolyte composition varies between the ECF and ICF, though the overall concentration of the electrolytes is approximately the same in the two compartments. · The measurement of electrolytes is important in evaluating electrolyte balance, as well as in determining the composition of electrolyte preparations. MECHANISMS CONTROLLING FLUID AND ELECTROLYTE MOVEMENT · Many different processes are involved in the movement of electrolytes and water between the ICF and ECF. Some of these include simple diffusion, facilitated diffusion, and active transport. Two forces...
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...Acid-Base Balance Kelly Heffron Grand Canyon University NUR-614 September 16, 2015 Acid-Base Balance The acid base balance is a homeostatic process that aides the body in maintaining a pH in the arterial blood between 7.35-7.45 (Patient, 2015). The body works together through multi-systems to ensure that acidity or alkalinity never take over within the blood. The purpose of the following paper is define the classification of the acid-base balance, define the factors from the case study, explain the pathophysiology, describe the compensatory mechanisms, pharmacological interventions, and the educational needs of patients with an imbalance. Classification In the following case study, the patient presents with metabolic alkalosis. Metabolic acidosis is a state within the blood when sodium bicarbonate (HCO3) increases. This condition can arise when the there is an acid loss within the body and HCO3 in the blood increases (Merk Manual, 2015). This process can cause the intracellular shifting of hydrogen ions, thus causing HCO3 retention. In the case study it is identified that the kidneys have a higher content of HCO3 because of the volume depletions. Normally, the kidneys filter out the HCO3 and excrete it into the urine (Merk Manual, 2015). In the case study, compensatory mechanisms have not activated, because the PaO2 is still within normal range of 35-45mm Hg, with a level of 40mm Hg. When excretion does not occur, the acid-base balance shifts from homeostasis...
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...Maryjoyce Rotella The acid-base balance in the body largely depends on the hydrogen ion (H+) concentration. In general, high H+ makes the solution acidic with pH less than 7 while low H+ will make the solution basic or alkaline with pH higher than 7 (Lewis, 2013). Acidosis develops when the arterial pH drops below 7.35 while alkalosis develops when the arterial pH rises above 7.45 (Appel & Downs, 2008). The normal metabolic balance generally keeps the carbonic acid and bicarbonate ion to 1: 20 ratio. As the ratio changes, the body will respond to acid-base imbalance through compensation mechanisms to control acids through buffer system by either releasing or taking up H+ depending on the pH changes. Deviations from normal PCO2 cause respiratory problems while deviations from the normal HCO3− cause metabolic problems. Respiratory alkalosis is a condition that occurs when there is carbonic acid deficit as PaCO2 drops to less than 35 mm Hg. The blood pH increases while PaCO2 decreases but the bicarbonate (HCO3−) undergoes no changes (Apple & Downs, 2008). Respiratory alkalosis is primarily caused by hyperventilation due to conditions that stimulate the respiratory center such as oxygen deficiency at high altitudes, pulmonary diseases, congestive heart failure, and acute anxiety. Respiratory acidosis occurs when there is carbonic acid excess that raises the blood levels of CO2 above 45 mmHg. The blood pH decreases...
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...ACID-BASE DISORDERS MADE SO EASY EVEN A CAVEMAN CAN DO IT Lorraine R Franzi, MS/HSM, RD, LDN, CNSD Nutrition Support Specialist University of Pittsburgh Medical Center Pittsburgh, PA I. LEARNING OBJECTIVES The clinician after participating in the roundtable will be able to: 1) Indicate whether the pH level indicates acidosis or alkalosis. 2) State whether the cause of the pH imbalance is respiratory or metabolic. 3) Identify if there is any compensation for the acid-base imbalance. II. INTRODUCTION Acid-Base balance is an intricate concept which requires an intimate and detailed knowledge of the body’s metabolic pathways used to eliminate the H+ ion. Clinicians may find it daunting to understand when first introduced to the subject. This roundtable session will demonstrate how to analyze blood gas levels in a very elementary manner so as to diagnose any acid-base disorder in a matter of minutes. The body is in a constant state of flux delicately stabilizing the pH so as to maintain its normalcy. In order to prevent untoward effects of alkalosis or acidosis the body has three major buffering systems that it uses to adjust the pH. They are: 1) Plasma protein (Prot-) 2) Plasma hemoglobin (Hb-) 3) Bicarbonate (HCO3-) The Bicarbonate-Carbonic acid system is the most dominate buffering system and controls the majority of the hydrogen ion (H+) equilibrium. Maintaining homeostasis when these acid-base shifts occur is vital to survival. Metabolic and respiratory...
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...School of Nursing, Midwifery and Interprofessional Studies. With reference to acid-base balance explore the role of the respiratory system in maintaining blood pH? ‘We live and die at the cellular level’ (Reid, 2011). Homeostasis is crucial for normal cellular function. Acid-base homeostasis is the part of human homeostasis and refers to the balance between the production and elimination of H+ hydrogen ions (pH) within the body fluids (William, Simpkins, 2001, p.236). Metabolic reactions within the cells often produce a huge excess of H+. Lack of any mechanism for its excretion would lead H+ levels in body fluids rise quickly to the lethal levels (Tortora, Grabowski 2006, p.1001); therefore the homeostasis of the right H+ levels is crucial for our survival. In a healthy person several systems work interdependently on maintaining blood’s pH (Sheldon, 2001, p.23): buffer, renal and respiratory systems. In this essay I will concentrate on the pH of the blood in relation to the acid-base balance and the role that respiratory system has in maintaining it. Blood pH is a measure of its acidity or alkalinity. A pH of 7.4 is considered neutral in the systemic arterial blood within its narrow range of around 7.35 and 7.45. When the pH is greater than 7.45 the blood is considered to be alkalotic and when the pH is lower than 7.35 then the blood is considered acidotic (Sheldon, 2001, p.23). Fig. 1: Diagram of blood pH scale: (JupiterIonizer, 2004) The acidity or alkalinity...
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...Nurs 2820 Fluid, Electrolyte, and Acid-Base Balance Name: _______________________________________ Case Study Jimmy Lewis is brought to the hospital emergency room by some friends. He had been vomiting for several days and was complaining of heart palpitations. Mr. Lewis is a 58-year-old white male who is homeless. He has not had any health care for at least 10 years. He is an alcoholic and drinks a quart of gin or vodka every day. He does not have a job, and his family is all out of state. The emergency physician does an initial assessment and transfers him to a hospitalist, who admits him to a medical-surgical unit for further evaluation and treatment. Mr. Lewis has lab work drawn. His electrolytes are as follows: sodium 138 mEq/L, potassium 3.1 mEq/L (low), chloride 104 mEq/L, and magnesium 1.5 mEq/L (low). His arterial blood gas measurements are as follows: pH 7.48 (high), PaCO2 40 mm Hg, HCO3 29 (high). Jamie Taylor, a 22-year-old nursing student, is assigned to Mr. Lewis. She reviews Mr. Lewis’ medical record before going in to assess him. 1. After reviewing his chart and lab work, what fluid and electrolyte imbalances would Jamie determine? (Select all that Apply) A. Fluid volume deficit B. Hypokalemia C. Hypermagnesemia D. Hyperkalemia E. Hypomagnesemia 2. What acid-base imbalance is Mr. Lewis experiencing? A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis 3. The hospitalist orders an IV of D5NS to...
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...“Chemical Kinetcs – The hydrolysis of PNA Ester” Introduction: Reaction of a compound with water can result in a splitting, or lysis, of the compound into two parts. Organic molecules containing a group of atoms called an ester can be hydrolyzed by water to form a –COOH group (carboxylic acid) and an HO-- group (alcohol) as follows: RCOOR’ + H2O ( RCOOH + HOR’ This reaction is spontaneous for almost all esters but can be very slow under typical conditions of temperature and pressure. The reaction occurs at a much faster rate if there is a significant amount of base (OH-) in the solution. In this lab experiment, the rate of this reaction will be studied using an ester called para-nitrophenyl acetate (PNA), which produces an alcohol, para-nitrophenol (PNP). Question: What is the rate of reaction for the hydrolysis of PNA? What is the rate constant k? How are the rate of reaction and the rate constant k affected by varying (1) substrate PNA concentration, and (2) changes in pH (OH- base concentration) and addition of different nitrogen-containing base compounds (i.e.catalysts)? Hypothesis: I hypothesize that the rate of reaction and the rate constant for the hydrolysis of PNA can be determined experimentally to be first order. Also, in the reaction, the experiment will develop as follows: PNA +H2O --> PNP (yellow) + Ac Materials and Methods: The following solutions will be used in the experiment. 1. 0.2 M Phosphate Buffer, pH 6.5 (13.6 g KH2PO4 / 0.5 L, adjust...
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...och baser (Answers on page 18) Topic: Acid-Base Definitions 1. According to the Lewis definition, a base is a(n): A) Proton donor. B) Electron pair donor. C) Hydroxide ion donor. D) Hydrogen ion donor. E) Electron pair acceptor. 2. Which of the following is not both a Bronsted-Lowry acid and a Bronsted-Lowry base? A) HSO4! B) H2PO4! C) HCO3! D) OH! E) SH! 3. Which of the following is not a conjugate acid - conjugate base pair (in that order)? A) H3PO4, H2PO4! B) HBF4, BF4! C) CH3CH2OH, CH3CH2O! D) H3O+, H2O E) HPO4!, H2PO4! 4. The conjugate base of sulfuric acid is: A) H3SO4+ B) SO3 C) HSO4! D) H2SO3 E) HSO3! A) B) C) D) E) Topic: Acid-Base Definitions 6. Which of these is not a true statement? A) All Lewis bases are also Bronsted-Lowry bases. B) All Lewis acids contain hydrogen. C) All Bronsted-Lowry acids contain hydrogen. D) All Lewis acids are electron deficient. E) According to the Bronsted-Lowry theory, water is both an acid and a base. 7. For the equilibrium CH3NH3+ + H2O CH3NH3+ + H3O+ the two substances which both are acids are: A) H2O and H3O+ B) CH3NH3+ and H2O C) CH3NH3+ and CH3NH2 D) CH3NH3+ and H3O+ E) CH3NH2 and H2O 8. Which of the following is not a Lewis base? A) NH3 B) H! C) BF3 D) H2O E) H3C! 9. Which of the following is not a Bronsted-Lowry acid? A) H2O B) (CH3)3N C) NH4+ D) CH3CO2H E) HC"CH 5. Consider the equilibrium. Which are the Bronsted-Lowry bases? PO43- + H2O Chapter 3 HPO42- +...
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...Amphoterism From Wikipedia, the free encyclopedia (Redirected from Ampholytes) Jump to: navigation, search "Amphoteric" redirects here. For other uses, see Amphoteric (disambiguation). Acids and bases | | * Acid dissociation constant * Acid-base extraction * Acid–base reaction * Acid–base titration * Dissociation constant * Acidity function * Buffer solutions * pH * Proton affinity * Amphoterism * Self-ionization of water * Acid strength | Acid types | * Brønsted · * Lewis · * Mineral · * Organic · * Strong · * Superacids · * Weak | Base types | * Brønsted · * Lewis · * Organic · * Strong · * Superbases · * Non-nucleophilic · * Weak | * v · * t · * e | In chemistry, an amphoteric species is a molecule or ion that can react as an acid as well as a base.[1] The word is derived from the Greek word amphoteroi (ἀμφότεροι) meaning "both". Many metals (such as zinc, tin, lead, aluminium, and beryllium) form amphoteric oxides or hydroxides. Amphoterism depends on the oxidation state of the oxide. One type of amphoteric species are amphiprotic molecules, which can either donate or accept a proton (H+). Examples include amino acids and proteins, which have amine and carboxylic acid groups, and self-ionizable compounds such as water and ammonia. Ampholytes are amphoteric molecules that contain both acidic and basic groups and will exist mostly as zwitterions in a certain range...
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...THEORIES OF ACIDS AND BASESThis page describes the Arrhenius, Bronsted-Lowry, and Lewis theories of acids and bases, and explains the relationships between them. It also explains the concept of a conjugate pair - an acid and its conjugate base, or a base and its conjugate acid. | | | The Arrhenius Theory of acids and basesThe theory * Acids are substances which produce hydrogen ions in solution. * Bases are substances which produce hydroxide ions in solution.Neutralisation happens because hydrogen ions and hydroxide ions react to produce water.Limitations of the theoryHydrochloric acid is neutralised by both sodium hydroxide solution and ammonia solution. In both cases, you get a colourless solution which you can crystallise to get a white salt - either sodium chloride or ammonium chloride.These are clearly very similar reactions. The full equations are:In the sodium hydroxide case, hydrogen ions from the acid are reacting with hydroxide ions from the sodium hydroxide - in line with the Arrhenius theory.However, in the ammonia case, there don't appear to be any hydroxide ions!You can get around this by saying that the ammonia reacts with the water it is dissolved in to produce ammonium ions and hydroxide ions:This is a reversible reaction, and in a typical dilute ammonia solution, about 99% of the ammonia remains as ammonia molecules. Nevertheless, there are hydroxide ions there, and we can squeeze this into the Arrhenius theory.However, this same reaction also happens...
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... Purpose: What is the purpose of this lab? In your OWN words! Observations: Weighed out 3.2568 grams of chemical mixture that was yellow in color. Dissolved dry chemicals in 38 ml CH2Cl2 with gentle heating. Poured the yellow solution into sep funnel. Added 10 ml CH2Cl2 to flask to rinse, poured solution into sep funnel. Added 15 ml 3 M HCl, gently mixed and vented (saw bubbles during mixing, heard the evolution of gas while venting). Allowed layers to separate. Upper layer determined to be aqueous by density: lower layer removed. Upper layer placed into separate flask labeled “A” for acid extract. Lower layer placed into sep. funnel and reextracted with 15 ml 3 M HCl. Combined aqueous layers in flask A Reextracted CH2Cl2 layer containg chemicals with 15 ml 3 M NaOH. Upper layer in flask labeled “B” for base extract. Re-extract organic layer with 15 ml 3M NaOH. Combined base extracted materials in flask “B”. Saw bubbles during mixing, heard the evolution of gas while venting. Dried organic layer with anhyd. Na2SO4 until free flowing salt was observed (about 3 grams). Filtered the organic solution into a tared 100 ml round-bottom flask. Rinsed flask and funnel with 10 ml of CH2Cl2 and rotovaped off remaining solvent and weighed flask. The biphenyl obtained was white in color and was like a powder. Weight of flask and biphenyl = 106.1784 g Weight of empty flask = 104.7368 g Weight of recovered biphenyl = 1.4416 Cooled flask A in a water bath. Added 18 ml...
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...Post-Lab Questions 1) a. The relationship of the pH to the ratio of concentrations of the conjugate base to conjugate acid is based on the Henderson Hasselbalch equation, pH=pKA+ log([conjugate base] / [conjugate acid]). The graph of the relationship between pH and this ratio showed to increase rapidly at first, and then more slowly. This shows a logarithmic curve and that the relationship of the ratio is a logarithmic function of pH. When pH was graphed with the log of this ratio, the graph became linear, showing the directly proportional relationship between pH and the log of the ratio of conjugate base to conjugate acid. This proves the Henderson Hasselbalch equation. b. The addition of a strong acid would decrease the pH, since water is a neutral solution. It has nothing to account for the increase of H+ ions. The addition of a strong acid to the buffer, however, would generally not affect the pH. The buffer has a conjugate base which would be able to accept the excess of H+ ions, therefore not greatly effecting the pH. H3O+ would form, which would then react with A- to form HA and H2O. c. Diluting the acid would overall increase the pH of the solution. The dilution would cause an increase in volume, while the moles of H+ ions remains the same, therefore decreasing the concentration of H+ ions. If sufficiently diluted, the solution would become neutral with a pH of 7. d. The pH value of our most diluted buffer sample compared to our undiluted sample were not...
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...Acid-base disturbances The Acid Base Imbalance Regulation of hydrogen ion concentration in the body is a necessity for normal body functions.1 H + concentration in all body fluids are maintained to maintain pH ranges within narrow limits, this service is known as the balance acid-base (AB) 2.Arterial blood pH is maintained between 7.35-7.45, venous blood remains near 7,352. Most diseases / conditions disrupt AB, AB changes may be more harmful than the initial pathology. When AB is affected, causing the pH to vary from its limits, is called an acid-base (ABI) imbalance 2 However, there are processes instead of ABI less likely to occur. AB is maintained sequentially by several mechanisms: chemical buffers, respiratory system and renal system 3. Acid-Base Imbalance ABI is an irregularity in the body's balance of acids and bases. These deviations cause blood pH deviates outside its normal range. Imbalances can become life threatening. When an excess of acid causes pH to fall below 7.35 result in acidosis1. An excess base, causing it to rise above pH 7.45 alkalosis1 called. The imbalance is classified according to the origin of the disturbance (respiratory or metabolic) and the direction of change in pH (acidosis or alkalosis) 2 Thus may occur for example four alkalosis metabolic processes (MK), metabolic acidosis (MA ), respiratory alkalosis (RK) and respiratory acidosis (RA) 2. imbalance causes The general reasons for the accumulation of acid are usually Poor carbon...
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...Acid base medical conditions Dominique Naudy Kaplan University Respiratory acidosis is a medical condition that occurs when the lungs cannot get rid of all the carbon dioxide that is produced by the body. When there is too much carbon dioxide in the human body it causes the blood to become too acidic. There are two types of respiratory acidosis. They are chronic respiratory acidosis, and acute respiratory acidosis. Chronic happens over a long period of time, “This leads to a stable situation, because the kidneys increase body chemicals, such as bicarbonate, that help restore the body's acid-base balance.” (Dugdale, 2012 para 2) Acute respiratory acidosis occurs when the carbon dioxide accumulates in the body extremely fast, and the kidneys cannot balance the body. For a diagnosis of clinical acidosis there has to be low arterial pH (<7.36. As well as pCO2 and an increase in the plasma [HCO3-]. The normal range for pH is between 7.35-7.45, normal range for PCO2 is between 36-44 and normal range for HCO3- 22-26. When a person has respiratory acidosis the pH decreases, the PCO2 increases and HCO3 increases. (University of Iowa, 2015) Compensatory mechanism is the way the body reacts to maintain homeostasis. The body uses its own mechanisms to counteract an acid base disorder. When a patient has a chronic respiratory disorder the “kidneys can compensate for chronic respiratory disorders by either holding on to or dumping bicarbonate.” (UCSF, 2003 para 1). When a patient...
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