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Pulmonary TJ > 2.4.1 Interpreting Arterial Blood Gases > Flashcards

2.4.1 Interpreting Arterial Blood Gases Flashcards

1
Q

What are the two organ systems that could lead to an acid-base disorder?

A

Kidneys and Lungs

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2
Q

What two tests are needing for diagnosing an acid-base disorder?

A

Blood chemistry (electrolytes) and arterial blood gases

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3
Q

What are the normal values for pH, PCO2, and PO2?

A

pH: 7.4 (7.38-7.42)

PCO2: 40 (38-42)

PO2: 80, depends on age (104 - 0.27{age})

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4
Q

What is the Henderson-Hasselbach equation?

A

pH = pKa + log [HCO3-]/ PCO2

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5
Q

What is the Kassirer-Bleich equation?

A

[H+] = 24 X PCO2/[HCO3-]

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6
Q

What is acidemia? alkalemia?

A

Acidemia: pH < 7.35-7.45

Alkalemia: pH > 7.35-7.45

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7
Q

Put the normal values into the KB equation.

A

[H+] = 24 x 40/24

[H+] = 40 = pH of 7.4

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8
Q

What are the two types of metabolic acidosis?

A

Anion gap

Non-anion gap (hypercholeremic)

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9
Q

Metabolic disorders lead to irregularities in which value?

A

Bicarbonate

Metabolic acidosis (HCO3 retention/overproduction); Metabolic alkalosis (HCO3 depletion)

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10
Q

What are some causes of metabolic alkalosis?

A

Nasogastric suctioning, vomiting

Diuretic therapy

Cushing Syndrome - ACTH excess

Hyperaldosteronism - Addison’s Dz

Exogenous therapy

Licorice ingestion

Alkali ingestion

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11
Q

What are some causes of anion gap metabolic acidosis? (there is a neumonic)

A

MUDPILES

Methanol

Uremia

DKA

Paraldehyde

INH/Iron

Lactic Acidosis

Ethylene Glycol

Salicylates/Starvation

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12
Q

What are some of the causes of non-anion gap metabolic acidosis?

A

HARD-UP

Hyperailmentation

Acetazolamide and other carbonic anhydrase inhibitors

Renal tubular acidosis

Diarrhea

Ureteroenteric fistula

Pancreaticoduodenal fistula

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13
Q

What formula is used to determine respiratory compensation?

A

The Winter Formula

expected pCO2 = (1.5 X [HCO3-]) + 8 +/- 2

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14
Q

What is the primary alteration in respiratory disorders?

A

pCO2

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15
Q

What are some causes of respiratory acidosis?

A

CNS depression

Neuromuscular disorder

Thoracic cage limitation

Acute obstruction

Chronic obstruction

Ventilator Malfunction

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16
Q

What are some causes of respiratory alkalosis?

A

Anxiety

CNS Disorders

Drugs - Salicylates, analeptics

Fever, sepsis

Pregnancy

Liver insufficiency

Hyperthyroidism

17
Q

What is the standard approach for understanding an acid-base disorder?

A
  1. Evaluate pt history
  2. Review ABG
    • What is the pH? Acidemic or alkalemic?
    • Primarily respiratory or metabolic disorder?
      • Look at arterial PaCO2 and serum bicarbonate level
    • If respiratory: acute or chronic disturbance?
    • If metabolic: anion gap or non-anion gap?
  3. Use Winter’s formula to determine appropriate respiratory compensation (for metabolic acidosis)
18
Q

What is the expected change in pH for an acute respiratory disturbance?

A

0.08 x (measured PaCO2-40)/10

19
Q

What is the expected change in pH for a chronic respiratory disturbance?

A

0.03 X (measured PaCO2-40)/10

20
Q

What is the equation for anion gap? What is a normal value?

A

AG = Na+ - (Cl- + HCO3-)

Normal is 12 or less

21
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?
22
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?
23
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?
24
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?
25
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?
26
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?
27
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?
28
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?
29
Q
  1. Is there a gap?
  2. Is the pCO2 appropriate?
  3. What are the problems?

Pulmonary TJ (38 decks)

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