5b

Question 1

Rule of 4

Answer 1

pH 7.4 +/- 0.04pCO2 40 +/- 4HCO3 24 +/- 4 BE -/+ 4

Question 2

PaO2 in venous vs arterial samples

Answer 2

venous PaO2 52 arterial PaO2 92

Question 3

define a mixed acid base disorder

Answer 3

if compensatory response exceeds or falls short of the expected response, a mixed disorder may be present

Question 4

respiratory disturbances

Answer 4

look at PaCO2decr alkalosisincr acidosis

Question 5

metabolic disturbances

Answer 5

look at HCO3incr alkalosisdecr acidosis

Question 6

respiratory acidosis

Answer 6

HYPOventilation (NM or structural diseases, toxins, cervical IVDD, airway obstruction)incr PaCO2compensatory retention of renal HCO3 (usually takes 3-5 days)

Question 7

respiratory alkalosis

Answer 7

HYPERvent (hypoxemia, lung dz, activation of central reps centers, pain, anxiety)decr PaCO2

Question 8

avoid hyper ventilation/respiratory alkalosis in what group of trauma patients

Answer 8

HEAD TRAUMA ( hi intracranial P patients)hypervent and low PaCO2 causes cerebral vasoconstrictiondecrease cerebral blood flow

Question 9

metabolic acidosis

Answer 9

HCO3 decr (loss from kidneys, GI)

Question 10

anion gap

Answer 10

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

Question 11

causes of high AG

Answer 11

Metabolic acidosisK–ketonesL –lactic acidU–uremic acidE–ethylene glycol toxS–salicylate tox

Question 12

acid base status of addisonian patient

Answer 12

metabolic acidosis with hypochloremia (normal AG)

Question 13

sodium bicarbonate dosing

Answer 13

to treat metabolic acidosisgoal pH 7.2mEq bicarb = 0.3 x kg x base deficit

Question 14

metabolic alkalosis

Answer 14

incr HCO3due to loss of Cl (vomiting, suction GI contents, admin diuretics) or gain in exogenous alki

Question 15

T/F a patient can have concurrent respiratory alkalosis and acidosis

Answer 15

FALSE a patient can have any combo of two primary disorders EXCEPT respiratory acidosis/alkalosis