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NUR 406: exam 1 (CV, ABG, acid-base) > ABG > Flashcards

ABG Flashcards

1
Q

purpose of ABG’s

A

to assess acid-base status and determine adequacy of oxygenation and ventilation

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2
Q

ABG: pH

A

balance of H+
7.35-7.45

< = acidic
> = basic

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3
Q

PaCO2

A

35-45 mmHg

respiratory parameter
carbonic acid dissolves into CO2 and H2O
partial pressure of CO2 in ARTERY

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4
Q

HCO3

A

22-26 mEq/L

metabolic parameter
*measured HCO3 is reported as CO2 on a chemistry panel (serum CO2)

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5
Q

venous blood gas:
pH
PvCO2

A

pH: 7.31-7.41
PvCO2: 41-51 (partial pressure of CO2 in VEIN)

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6
Q

basic metabolic panel (BMP):
serum CO2 =

A

HCO3 level
22-26 mmol/L

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7
Q

primary EVENT

A

PROBLEM that initiates imbalance

*hypoventilation
*hyperventilation
*V/D

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8
Q

primary DISORDER

A

what RESULTS from the primary event

*respiratory acidosis (hypovent)
*metabolic acidosis (hypervent)
+ “” alkalosis

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9
Q

compensation mechanisms

A

physiologic processes that adjust the pH back to normal range

*if lungs are problem - kidneys compensate
*if kidneys are problem - lungs compensate

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10
Q

metabolic cause

A

HCO3 (bicarbonate) level changes d/t METABOLIC alterations (KIDNEY)

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11
Q

respiratory cause

A

H2CO3 (carbonic acid) level changes d/t RESPIRATORY alterations (LUNGS)

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12
Q

4 types of imbalances are a result of

A

changes in ventilation
increase/decrease in CO2
changes in H+ or bicarbonate ions

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13
Q

ROME

A

respiratory - opposite

metabolic - equal

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14
Q

metabolic acidosis: primary/compensation/pH

A

decrease HCO3
decrease CO2
decrease pH

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15
Q

metabolic alkalosis: primary/compensation/pH

A

increase HCO3
increase CO2
increase pH

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16
Q

respiratory acidosis: primary/compensation/pH

A

increase CO2
increase HCO3
decrease pH

17
Q

respiratory alkalosis: primary/compensation/pH

A

decrease CO2
decrease HCO3
increase pH

18
Q

metabolic alkalosis

A

too much HCO3 OR not enough carbonic acid

pH > 7.45
CO2 35-45
HCO3 > 26

19
Q

causes of metabolic alkalosis

A

-excess baking soda/sodium bicarb
-prolonged vomiting
-NG tube (GI suctioning)
-diuretics (esp. loop)

20
Q

clinical manifestation of metabolic alkalosis

A

CNS over excitability –> leads to fatigue
confusion
tremors
muscle cramps
paresthesias
coma
N/V/D
respiratory depression - compensatory hypoventilation
dysrhythmias (tachycardia)
hypokalemia

21
Q

respiratory alkalosis

A

H2CO3 (carbonic acid) DEFICIT in ECF

pH > 7.45
CO2 < 35
HCO3 22-26

22
Q

cause of respiratory alkalosis

A

hyperventilation (CO2 blown off)
increased metabolic demands (d/t fever, sepsis)
meds
acute anxiety
hypoxia
PE or lung disease
CNS lesions
ventilator settings

23
Q

clinical manifestations of respiratory alkalosis

A

CNS over excitability
tachypnea + hyperventilation (deep and rapid)
light headedness
confusion, blurred vision
paresthesia
hyperactive reflexes
seizures
coma
tachycardia
hypokalemia

24
Q

respiratory acidosis

A

excess carbonic acid/ H2CO3
*hypoventilation – retained CO2

pH < 7.35
CO2 > 45
HCO3 22-26

25
Q

acute respiratory acidosis

A

HCO3 WNL
no time for kidneys to compensate

*resp arrest

chronic - COPD/oversedation

26
Q

causes of respiratory acidosis

A

cardiopulmonary arrest
head injury
narcotics/sedatives
anesthesia
pulmonary disorders (COPD exacerbation, acute asthma, PNA, resp failure)
pain
abd distention
airway obstruction
chest wall deformities
neuromuscular problems

27
Q

clinical manifestations of respiratory acidosis

A

CNS depressing…
HYPOventilation
dyspnea
respiratory distress
H/A
restlessness
confusion
tachycardia
arrhythmias
decreased LOC, stupor, coma

28
Q

metabolic acidosis

A

HCO3 DEFICIT in ECF
excess acids are added or bicarb is lost

pH < 7.35
CO2 35-45
HCO3 < 22

IF lungs compensating, respirations increased and CO2 decreased

29
Q

clinical manifestation of metabolic acidosis

A

CNS…
lethargic, drowsy
confusion
tremors, muscle cramps
parasthesias
H/A

hypotension
hyperkalemia
warm, flushed skin (vasodilation)
*deep breathing (KUSSMAUL RESPIRATIONS [DKA])
*fruity odor breath [DKA]

30
Q

causes of metabolic acidosis

A

renal failure
fistulas
T1DM - DKA
lactic acidosis
prolonged diarrhea
starvation (body using fat for energy resulting in ketosis)
med overdose (ASA)
shock and cardiac arrest (begin to produce lactic acid from lack of oxygen in tissues)

31
Q

respiratory acidosis/alkalosis: compensation

A

KIDNEYS compensates by:
-conserving HCO3
-excreting HCO3

takes kidneys HOURS TO DAYS to compensate

32
Q

metabolic acidosis/alkalosis: compensation

A

LUNGS compensate by:
-conserving CO2
-excreting CO2
(the kidneys also attempts to correct imbalance by retaining/excreting HCO3)

takes lungs MINUTES TO HOURS to compensate

NUR 406: exam 1 (CV, ABG, acid-base) (6 decks)

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