ABG Flashcards
1
Q
Co² loss =
A
H ion production
2
Q
Ratio of carbonic acid to bicarbonate
A
1 carbonic acid : 20 Bicarbonate
3
Q
Normal Values for
Arterial pH
A
Acid 7.35 - 7.45 Base
4
Q
Normal Values for
PaCo²
A
Base 35 - 45 Acid
5
Q
Normal Values for
HCo³
A
Acid 22 - 26 Base
6
Q
Normal Values for
SPo²
A
> 95%
7
Q
Normal Values fo
RBC
F & M
A
F 4.2 - 5.4 M
M 4.7 - 6.1
8
Q
Normal Values for
HgB
F & M
A
F 12 - 15
M 14 - 17
9
Q
Normal Values for
Hct
F & M
A
F 36 - 46%
M 42 - 52%
10
Q
Normal Values for
WBC
A
5,000 - 10,000
11
Q
Normal Values for
Platelets
A
200,000 - 450,000
12
Q
Which values can kill in Arterial blood gas
A
<6.8
> 7.8
13
Q
Is Bicarb a (weak / strong) base
A
Weak
14
Q
What is the major buffer (1st line defense) in the body
A
Hemoglobin
15
Q
1st
2nd
3rd
Line of defense against body pH imbalance
A
1st Buffer = hemoglobin
2nd Lungs = Exhale carbon dioxide-Acid
3rd Kidney = excrete / maintain Bicarb
16
Q
Human body is 50- 60% fluid
Which percentage is
Intracellular/ Extracellular
A
Intracellular: 35 - 40%
Extracellular: 15 - 20%
17
Q
Hydrogen ions
Overproduction/ Under elimination
(Metabolic/ Respitory)
(Acidosis/ Alkalosis)
A
Metabolic Acidosis
18
Q
Bicarbonate ions
Under-production / over-elimination
(Metabolic/ Respitory)
(Acidosis/ Alkalosis)
A
Metabolic Acidosis
19
Q
PaO² value in Metabolic Acidosis
PaCO² value in Metabolic Acidosis
A
PaO² = Normal 80 - 100
PaCO² = Normal or Slight decrease
35 - 45
20
Q
Serum Potassium
Metabolic Acidosis
Metabolic Alkalosis
A
> 5.3
<3.5
21
Q
Hallmark of respiratory acidosis
PaO² ____
PaCo² ____
A
PaO² <80
PaCo² >45
Decreased PaO² & Increased PaCo²
22
Q
Beta-2 agonists: These include salbutamol, salmeterol, formoterol, and vilanterol.
Anticholinergics: These include tiotropium, ipratropium, aclidinium, and glycopyrronium.
Theophylline: This is another type of bronchodilator
Are given to which type of patients
A
Metabolic Acidosis
Beta 2 agonist class of drugs that relax smooth muscles.They are commonly used to treat asthma and chronic obstructive pulmonary disease (COPD)
23
Q
Bronchodilators, Anti-inflammatory, Mucolytics
Given to this type of patient
A
Resp. ACIDOSIS
24
Q
Nsaids & corticosteroids are given to which type of patient
A
Resp acid
25
Evaluation of Effective therapy for Resp Acidosis
Arterial pH above ___
PaO² above ___ or 10 higher than admission
PaCo² below ___ or atleast 15 below admission
Arterial pH above 7.2
PaO² above 90 or 10 higher than admission
PaCo² below 45 or atleast 15 below admission
26
Hydration issue or Drug Therapy can cause
Metabolic Acidosis
27
Insulin to treat DKA, Antidiarrheal, bicarbonate
Used to treat
Metabolic Acidosis
28
Excessive intake of (bi)carbonate, acetates, citrates
Gives this condition
Metabolic Alkalosis
29
Prolonged vomiting, excess cortisol, Hyperaldosteronism, thiazide diuretics, Prolonged NG suction
Give this condition
Metabolic Alkalosis
30
HCo³ is 3rd line of defense and eliminated by the kidneys
What is HCo³
Bicarbonate
31
ABG pH >7.45
HCo³ > 26
PaO² 80 - 100 (Norm)
PaCO² 35 - 45 (Norm)
Is Hallmark for this condition
Metabolic Alkalosis
32
Causes
Hyperventilation, improper vent settings, Fever, CNS lesion, Salicylates
Resp Alk
33
ABG
>7.45 pH
<35 PaCo²
80 - 100 PaO² (normal)
22 - 26 HCo³ (bicarb) normal
Resp Alkalosis
34
Hypocalcemia <8.5
Hypokalemia <3.5
Are signs of
Metabolic/ Respitory Alkalosis
35
Positive Chvostek (facial twitching) /
Trousseau's (spasm of carpopedal after wearing a BP cuff 2/3 min)
Are associated with
Metabolic/ Respitory Alkalosis
Hypocalcemia <8.5
36
Tetany is....
Associated with...
involuntary muscle contractions
Hypocalcemia
Metabolic/ Respitory Alkalosis
37
Prevent further loss of
Hydrogen ions
K
Ca
Chloride
Alkalosis
38
Why do we modify / stop NG suction with Alkalosis?
NG sucks stomach acid containing H ions
39
Type if solution to give for Alkalosis
Isotonic
40
Patient with respitory depression is more likely to have this A/B condition
Respiratory Acidosis
41
K levels with Acidosis
K levels with Alkalosis
Acidosis = High >5.3
Alkalosis = Low < 3.5
42
(Acid / Base) Hydrogen Acceptor
(Acid / Base) Hydrogen Donor
Base = Hydrogen Acceptor
Acid = Hydrogen Donor
43
H2CO3 is....
Carbonic acid
Weak acid that forms when carbon dioxide (CO2) dissolves in water
44
Neutralize / Convert Strong Acid into Weak Acid
Is the function of..
Hemoglobin/ Buffer
45
pH is the measurement of...
Free Hydrogen ions
46
The more free H, the (High / Low), the pH
Lower
47
pH of body fluids
Gastric
1 - 5
48
pH of body fluids
Urine
5.5 - 6.5
49
pH of body fluids
Arterial Blood
7.35 - 7.45
50
pH of body fluids
Bile
7.5
51
pH of body fluids
Pancreas
8.4 - 8.9
52
Carbon dioxide + water =
Correct
carbonic acid (H2CO3)
53
Volatile acids are excreted from the lungs as vapor CO²
Non-volatile acids cannot form vapor and are excreted from the kidneys as HCo³ (bicarb)
T or F
T
54
The amount of (Oxygen/ Carbon Dioxide) in blood determines the rate of breathing in healthy people
Carbon Dioxide
55
Hyperventilation = (Acidosis/ Alkalosis)
Hypoventilation = (Acidosis/ Alkalosis)
Hyperventilation = Alkalosis
(Expells too much CO² "an Acid")
Hypoventilation = Acidosis
(Conserves too much CO² "an Acid")
56
Renal correction of Acidosis
More (H / HCo³) are secreted in Urine
More (H/HCo³) are reabsored into blood
More H are secreted in Urine
More HCo³ are reabsored into blood
57
Hyperkalemia/ hyperchloremia
(Acidosis/ Alkalosis)
Hypokalemia/ hypochloremia
(Acidosis/ Alkalosis)
Hyperkalemia/ hyperchloremia
Acidosis
Hypokalemia/ hypochloremia
Alkalosis
58
CNS effects
Depression, Drowsy, Unconscious
(Acidosis/ Alkalosis)
Twitching, Seizures
(Acidosis/ Alkalosis)
Depression, Drowsy, Unconscious
Acidosis
Twitching, Seizures
Alkalosis
59
____ must be preformed before radial artery cannulation
Allen's test
60
Describe Allen's test
What is a positive result
Patient squeezes fist
Nurse occuldes ulnar & radial arteries
Patient opens hand
Nurse removes occlusion from 1 artery
Hand regains color in <15 seconds
Positive = Normal, Color returns <15 secs
61
Compensation mechanism for Metabolic Acidosis
Kussmaul breathing
62
Ketoacidosis, starvation, lactic acidosis, shock
Lead to this A/B imbalance
Metabolic Acidosis
63
Ingestion of
Salicylate
Coccaine, Ecstasy, meth
Lead to this A/B imbalance
Metabolic Acidosis
64
Decreased excretion of H ion from
Renal failure
Causes this A / B imbalance
Metabolic Acidosis
65
Loss of HCO-
Diarrhea, bilary drainage, Ileostomy
Lead to this A/B imbalance
Metabolic Acidosis
66
Kussmaul
Drowsy, lower LOC
Warm Flushed skin
Clinical Manifestation of this A/B imbalance
Metabolic Acidosis
67
Overdose
Anesthesia
Cerebral trauma
Cardiac Arrest
Lead to this A/B imbalance
Respiratory Acidosis
68
Inadequate chest expansion
Gullian-barre syndrome
Airway obstruction
Lead to this A/B imbalance
Respiratory Acidosis
69
Kyphoscoliosis
Obesity
Polio,ALS, MS
Lead to this A/B imbalance
Respiratory Acidosis
70
Confusion
Lower LOC
Restlessness
Hypoventilation
Lead to this A/B imbalance
Respiratory Acidosis
71
Vomiting
NG tube loss
Diuretic therapy
Lead to this A/B imbalance
Metabolic Alkalosis
72
Irritated
Confused
Paresthesia, fingers, toes, mouth
Tetany
Muscle cramps
Seizures
Lead to this A/B imbalance
Metabolic Alkalosis
73
High altitude
Anemia
Pneumia
Chf
Anxiety, fear, pain
This A/B imbalance
Respiratory Alkalosis
74
salicylates are...
Asprins
75
Carbonic anhydrases (CAs) catalyze a reaction fundamental for life:
Describe...
the bidirectional conversion of carbon dioxide (CO2) and water (H2O) into bicarbonate (HCO3−) and protons (H+).
76
Where does the carbonic anhydrase reaction take place?
RBC in arterial blood
77
HCO3- (known as ____) is the conjugate base of H2CO3 (known as ____) , a weak acid, and the conjugate acid of the carbonate ion
bicarbonate / carbonic acid
78
What electrolyte issue is caused by acidosis
Acidosis
can cause hyperkalemia
. This is because acidosis causes potassium to shift from the intracellular to the extracellular compartment
79
The kidneys treat acidosis by secreting more ______ into the urine
H+ ions
Effect= more HCO3 ions are reabsorbed in the blood
80
The kidneys treat alkalosis by reabsorbing ______ into the blood
Absorb H+
Effect= more HCO3 ions are secreted in the urine
81
Acidosis/ Alkalosis
Sleepy, SOB, Weakness, increased HR, Diarrhea
Hand tremor, numbness/ tingling, twitching,
Both have: Confusion, Coma, N/V
Acidosis
Sleepy, SOB, Weakness, increased HR, Diarrhea
Alkalosis
Hand tremor, numbness/ tingling, twitching,
82
1 liter of fluid weighs ...
1 kilo = 2.2 lbs
83
Respiratory Alkalosis is associated with
Hypocalcemia/ Hypercalcemia
Hypocalcemia
S/S Increased muscle twitching
84
Hypercalcemia/ Hypocalcemia
Trousseau's sign (hand twitching with BP cuff)
Chvostek's sign (Facial twitching when the cheek is tapped)
Muscle twitching (tetany)
Numbness
Hypercalcemia/Hypocalcemia
Muscle weakness
Polydipsia, Polyuria, Constipation
Headache, N/V
Hypocalcemia = Muscle twitching
Hypercalcemia = Muscle weakness
85
Hypocalcemia VALUE
Hypercalcemia VALUE
Hypo <8.5
Hyper >10.5
86
Metabolic acidosis (decreases/increases) ionized calcium in the blood by reducing the amount of calcium bound to albumin
As pH increases, protein binding
increases, which ( decreases/ increases) free calcium levels.
Metabolic acidosis increases calcium in the blood
As pH increases, protein binding increases, which decreases free calcium levels.
87
SaO² Normal value
PaO² Normal value
SaO² Normal value >95
PaO² Normal value 80 - 100
88
(HCO3) acidic or basic?
Basic
Bicarbonate
89
Most common symptom of Respiratory Acidosis
Hypoventilation with hypoxia (CO2 buildup)
Warm, Flushed Skin
90
What happens to RBC, Hct, Hemoglobin levels with Dehydration
Increase
91
Elevated Serum Osmolality
BUN
Elevated levels indicate
Fluid volume Overload or Depletion
Depletion
Dehydration
92
Urine specific gravity range
What does outside normal mean
Excess Fluid 1.005–1.030 Dehydration
93
Serum Osmolality normal
Fluid excess 275 and 295 Dehydration
94
nurse is assessing a client who has respiratory acidosis. Which of the following findings should the nurse expect?
A. Confusion.
B. Peripheral edema.
C. Facial flushing and warmth.
D. Hyperreflexia.
A confused
95
what are the 2 electrolyte imbalances associated with acidosis
Hyperkalemia
Hypochloremia
96
what are the 2 electrolyte imbalances associated with alkalosis
Hypokalemia
Hyperchloremia
97
As pH goes, so does my patient, except for ____
Explain meaning
Except for K
Means: as ph goes down (acidosis) patients functioning goes down & as ph goes up so does patients functioning.
Except for K values.
Low pH = High K / High pH = Low K
98
All causes of ...
2. increased acid ingestion ( salicylates, cocaine, ecstasy, methamephetamines)
3. decreased excretion of H ions (renal failure)
4. loss of HCO3 (diarrhea, biliary drainage, ileostomy)
Metabolic Acidosis +
increased acid production (DKA, starvation, lactic acidosis, shock)
99
Salicylate poisoning causes...
Alkalosis or Acidosis
Both
respiratory alkalosis and, by an independent mechanism, metabolic acidosis
