ACTIVITY 5 –DETERMINATION OF Ph (BUYUCAN, S.I.

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1. Discuss the Acid-Base Balance Mechanism of the human body.

Your body's pH balance, also referred to as its acid-base balance, is the level of acids and bases in your blood at
which your body functions best. The human body is built to naturally maintain a healthy balance of acidity and
alkalinity. The lungs and kidneys play a key role in this process.

2. Differentiate the following Acid-Base imbalances in terms of results in Blood Gas Analysis and possible causes:

a. Metabolic Acidosis

Metabolic acidosis is primary reduction in bicarbonate (HCO 3−), typically with compensatory reduction in carbon
dioxide partial pressure (P CO2); pH may be markedly low or slightly subnormal. Metabolic acidoses are
categorized as high or normal anion gap based on the presence or absence of unmeasured anions in serum.
Causes include accumulation of ketones and lactic acid, renal failure, and drug or toxin ingestion (high anion
gap) and gastrointestinal or renal HCO 3− loss (normal anion gap). Symptoms and signs in severe cases include
nausea and vomiting, lethargy, and hyperpnea. Diagnosis is clinical and with arterial blood gas (ABG) and serum
electrolyte measurement. The cause is treated; IV sodium bicarbonate may be indicated when pH is very low.

b. Respiratory Acidosis

Respiratory acidosis is a state in which there is usually a failure of ventilation and an accumulation of carbon
dioxide. The primary disturbance of elevated arterial PCO2 is the decreased ratio of arterial bicarbonate to arterial
PCO2, which leads to a lowering of the pH. In the presence of alveolar hypoventilation, 2 features commonly are
seen are respiratory acidosis and hypercapnia. To compensate for the disturbance in the balance between carbon
dioxide and bicarbonate (HCO3-), the kidneys begin to excrete more acid in the forms of hydrogen and ammonium
and reabsorb more base in the form of bicarbonate. This compensation helps to normalize the pH. An arterial
blood gas (ABG) and serum bicarbonate level are necessary to evaluate patients with suspected respiratory
acidosis. Other tests can be conducted to evaluate the underlying causes. In respiratory acidosis, the ABG will show
an elevated PCO2 (>45 mmHg), elevated HCO3- (>30 mmHg), and decreased pH (<7.35). The respiratory acidosis
can be further classified as acute or chronic based on the relative increase in HCO3- with respect to PCO2. In cases
of acute respiratory acidosis, HCO3- will have increased by one mEq/L for every ten mmHg increase in PCO2 over a
few minutes. In cases of chronic respiratory acidosis, HCO3- will have increased by four mEq/L for every ten mmHg
increase in PCO2 over a time course of days. If the compensation does not occur in this pattern, a mixed
respiratory-metabolic disorder may be present. In a patient who presents with unexplained respiratory acidosis, a
drug screen may also be warranted.

c. Metabolic Alkalosis

Several different underlying conditions can cause metabolic alkalosis. These include:
Loss of stomach acids. This is the most common cause of metabolic alkalosis. It’s usually brought on by vomiting or
suction through a nose-feeding tube.The gastric juices have a high content of hydrochloric acid, a strong acid. Its
loss causes an increase in the alkalinity of the blood.The vomiting can result from any number of stomach
disorders. By figuring out and treating the cause of the vomiting, your doctor will cure the metabolic alkalosis.
Excess of antacids. Antacid use won’t normally lead to metabolic alkalosis. But if you have weak or failing kidneys
and use a nonabsorbable antacid, it can bring on alkalosis. Nonabsorbable antacids contain aluminum hydroxide or
magnesium hydroxide. Diuretics. Some diuretics (water pills) commonly prescribed for high blood pressure can
cause increased urinary acid secretion. The increased secretion of acid in the urine can make your blood more
alkaline. If alkalosis shows up when you’re taking drugs such as thiazide or loop diuretics, your doctor may ask you
to stop. Potassium deficiency (hypokalemia). A deficiency of potassium can cause the hydrogen ions normally
present in the fluid around your cells to shift inside the cells. The absence of acidic hydrogen ions causes your fluids
and blood to become more alkaline. Reduced volume of blood in the arteries (EABV). This can come from both a
weakened heart and from cirrhosis of the liver. A reduced blood flow impairs your body’s ability to remove the
alkaline bicarbonate ions. Heart, kidney, or liver failure. Metabolic alkalosis can be caused by failure of a major
organ, such as your heart, kidney, or liver. This leads to potassium depletion. A standard saline solution (sodium
chloride) can make things worse by causing your body to retain fluids without getting rid of the excess of
bicarbonate ions that are causing the alkalosis.
d. Respiratory Alkalosis

PaCO2 > 40 with a pH < 7.4 indicates a respiratory acidosis, while PaCO2 < 40 and pH > 7.4 indicates a respiratory
alkalosis (but is often from hyperventilation from anxiety or compensation for a metabolic acidosis. cute
respiratory alkalosis causes light-headedness, confusion, peripheral and circumoral paresthesias, cramps, and
syncope. Mechanism is thought to be change in cerebral blood flow and pH. Tachypnea or hyperpnea is often the
only sign; carpopedal spasm may occur in severe cases due to decreased levels of ionized calcium in the blood
(driven inside cells in exchange for hydrogen ion [H+]). Chronic respiratory alkalosis is usually asymptomatic and
has no distinctive signs.

3. What is the importance of determining the pH of body fluids of individuals?

Regulation of body fluid pH is one of the most important physiological functions of homeostasis, because activity
of most chemical reactions via enzyme proteins is dependent on fluid pH.

4. You have a patient with urinary tract infection or UTI. Will it be useful to determine the pH of the urine of
your patient? Why?

A urine pH level test analyzes the acidity or alkalinity of a urine sample. It’s a simple and painless test. Many
diseases, your diet, and the medications you take can affect how acidic or basic (alkaline) your urine is. For
instance, results that are either too high or low can indicate the likelihood that your body will form kidney stones.
If your urine is at an extreme on either the low or high end of pH levels, you can adjust your diet to reduce the
likelihood of painful kidney stones. In short, your urine pH is an indicator of your overall health and gives a doctor
important clues as to what’s going on in your body. In this article, we’ll go over what a normal urine pH level looks
like, as well as when you need to test it, and look at the test itself. Kidney stones tend to form in a highly acidic or
basic environment, so a doctor may test your urine to determine the likelihood that you’ll develop kidney stones.
These small masses of minerals can collect in the kidneys and cause pain as they prevent urine from passing
through your kidneys and urinary system. Certain medications can affect your urine pH too. A doctor may order
the urine pH level test to determine whether your medications are making your urine too acidic. The urine pH level
test can also help a doctor determine the best medication to prescribe when you have a urinary tract infection
(UTI).