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NURS 1355 > ABG > Flashcards

ABG Flashcards

1
Q

Co² loss =

A

H ion production

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2
Q

Ratio of carbonic acid to bicarbonate

A

1 carbonic acid : 20 Bicarbonate

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3
Q

Normal Values for

Arterial pH

A

Acid 7.35 - 7.45 Base

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4
Q

Normal Values for

PaCo²

A

Base 35 - 45 Acid

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5
Q

Normal Values for

HCo³

A

Acid 22 - 26 Base

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6
Q

Normal Values for

SPo²

A

> 95%

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7
Q

Normal Values fo

RBC

F & M

A

F 4.2 - 5.4 M

M 4.7 - 6.1

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8
Q

Normal Values for

HgB

F & M

A

F 12 - 15

M 14 - 17

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9
Q

Normal Values for

Hct

F & M

A

F 36 - 46%

M 42 - 52%

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10
Q

Normal Values for

WBC

A

5,000 - 10,000

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11
Q

Normal Values for

Platelets

A

200,000 - 450,000

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12
Q

Which values can kill in Arterial blood gas

A

<6.8

> 7.8

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13
Q

Is Bicarb a (weak / strong) base

A

Weak

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14
Q

What is the major buffer (1st line defense) in the body

A

Hemoglobin

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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

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16
Q

Human body is 50- 60% fluid

Which percentage is

Intracellular/ Extracellular

A

Intracellular: 35 - 40%

Extracellular: 15 - 20%

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17
Q

Hydrogen ions

Overproduction/ Under elimination

(Metabolic/ Respitory)

(Acidosis/ Alkalosis)

A

Metabolic Acidosis

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18
Q

Bicarbonate ions

Under-production / over-elimination

(Metabolic/ Respitory)

(Acidosis/ Alkalosis)

A

Metabolic Acidosis

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19
Q

PaO² value in Metabolic Acidosis

PaCO² value in Metabolic Acidosis

A

PaO² = Normal 80 - 100

PaCO² = Normal or Slight decrease
35 - 45

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20
Q

Serum Potassium

Metabolic Acidosis

Metabolic Alkalosis

A

> 5.3

<3.5

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21
Q

Hallmark of respiratory acidosis

PaO² ____

PaCo² ____

A

PaO² <80

PaCo² >45

Decreased PaO² & Increased PaCo²

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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)

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23
Q

Bronchodilators, Anti-inflammatory, Mucolytics

Given to this type of patient

A

Resp. ACIDOSIS

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24
Q

Nsaids & corticosteroids are given to which type of patient

A

Resp acid

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25
Q

Evaluation of Effective therapy for Resp Acidosis

Arterial pH above ___
PaO² above ___ or 10 higher than admission
PaCo² below ___ or atleast 15 below admission

A

Arterial pH above 7.2

PaO² above 90 or 10 higher than admission

PaCo² below 45 or atleast 15 below admission

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26
Q

Hydration issue or Drug Therapy can cause

A

Metabolic Acidosis

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27
Q

Insulin to treat DKA, Antidiarrheal, bicarbonate

Used to treat

A

Metabolic Acidosis

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28
Q

Excessive intake of (bi)carbonate, acetates, citrates

Gives this condition

A

Metabolic Alkalosis

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29
Q

Prolonged vomiting, excess cortisol, Hyperaldosteronism, thiazide diuretics, Prolonged NG suction

Give this condition

A

Metabolic Alkalosis

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30
Q

HCo³ is 3rd line of defense and eliminated by the kidneys

What is HCo³

A

Bicarbonate

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31
Q

ABG pH >7.45
HCo³ > 26

PaO² 80 - 100 (Norm)
PaCO² 35 - 45 (Norm)

Is Hallmark for this condition

A

Metabolic Alkalosis

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32
Q

Causes

Hyperventilation, improper vent settings, Fever, CNS lesion, Salicylates

A

Resp Alk

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33
Q

ABG
>7.45 pH
<35 PaCo²

80 - 100 PaO² (normal)
22 - 26 HCo³ (bicarb) normal

A

Resp Alkalosis

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34
Q

Hypocalcemia <8.5
Hypokalemia <3.5

Are signs of

A

Metabolic/ Respitory Alkalosis

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35
Q

Positive Chvostek (facial twitching) /
Trousseau’s (spasm of carpopedal after wearing a BP cuff 2/3 min)

Are associated with

A

Metabolic/ Respitory Alkalosis

Hypocalcemia <8.5

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36
Q

Tetany is….

Associated with…

A

involuntary muscle contractions

Hypocalcemia

Metabolic/ Respitory Alkalosis

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37
Q

Prevent further loss of

Hydrogen ions
K
Ca
Chloride

A

Alkalosis

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38
Q

Why do we modify / stop NG suction with Alkalosis?

A

NG sucks stomach acid containing H ions

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39
Q

Type if solution to give for Alkalosis

A

Isotonic

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40
Q

Patient with respitory depression is more likely to have this A/B condition

A

Respiratory Acidosis

41
Q

K levels with Acidosis

K levels with Alkalosis

A

Acidosis = High >5.3

Alkalosis = Low < 3.5

42
Q

(Acid / Base) Hydrogen Acceptor

(Acid / Base) Hydrogen Donor

A

Base = Hydrogen Acceptor

Acid = Hydrogen Donor

43
Q

H2CO3 is….

A

Carbonic acid

Weak acid that forms when carbon dioxide (CO2) dissolves in water

44
Q

Neutralize / Convert Strong Acid into Weak Acid

Is the function of..

A

Hemoglobin/ Buffer

45
Q

pH is the measurement of…

A

Free Hydrogen ions

46
Q

The more free H, the (High / Low), the pH

A

Lower

47
Q

pH of body fluids

Gastric

A

1 - 5

48
Q

pH of body fluids

Urine

A

5.5 - 6.5

49
Q

pH of body fluids

Arterial Blood

A

7.35 - 7.45

50
Q

pH of body fluids

Bile

A

7.5

51
Q

pH of body fluids

Pancreas

A

8.4 - 8.9

52
Q

Carbon dioxide + water =

Correct

A

carbonic acid (H2CO3)

53
Q

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

A

T

54
Q

The amount of (Oxygen/ Carbon Dioxide) in blood determines the rate of breathing in healthy people

A

Carbon Dioxide

55
Q

Hyperventilation = (Acidosis/ Alkalosis)

Hypoventilation = (Acidosis/ Alkalosis)

A

Hyperventilation = Alkalosis
(Expells too much CO² “an Acid”)

Hypoventilation = Acidosis
(Conserves too much CO² “an Acid”)

56
Q

Renal correction of Acidosis

More (H / HCo³) are secreted in Urine

More (H/HCo³) are reabsored into blood

A

More H are secreted in Urine

More HCo³ are reabsored into blood

57
Q

Hyperkalemia/ hyperchloremia

(Acidosis/ Alkalosis)

Hypokalemia/ hypochloremia

(Acidosis/ Alkalosis)

A

Hyperkalemia/ hyperchloremia
Acidosis

Hypokalemia/ hypochloremia
Alkalosis

58
Q

CNS effects

Depression, Drowsy, Unconscious
(Acidosis/ Alkalosis)

Twitching, Seizures
(Acidosis/ Alkalosis)

A

Depression, Drowsy, Unconscious
Acidosis

Twitching, Seizures
Alkalosis

59
Q

____ must be preformed before radial artery cannulation

A

Allen’s test

60
Q

Describe Allen’s test

What is a positive result

A

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
Q

Compensation mechanism for Metabolic Acidosis

A

Kussmaul breathing

62
Q

Ketoacidosis, starvation, lactic acidosis, shock

Lead to this A/B imbalance

A

Metabolic Acidosis

63
Q

Ingestion of

Salicylate

Coccaine, Ecstasy, meth

Lead to this A/B imbalance

A

Metabolic Acidosis

64
Q

Decreased excretion of H ion from

Renal failure

Causes this A / B imbalance

A

Metabolic Acidosis

65
Q

Loss of HCO-

Diarrhea, bilary drainage, Ileostomy

Lead to this A/B imbalance

A

Metabolic Acidosis

66
Q

Kussmaul

Drowsy, lower LOC

Warm Flushed skin

Clinical Manifestation of this A/B imbalance

A

Metabolic Acidosis

67
Q

Overdose

Anesthesia

Cerebral trauma

Cardiac Arrest

Lead to this A/B imbalance

A

Respiratory Acidosis

68
Q

Inadequate chest expansion

Gullian-barre syndrome

Airway obstruction

Lead to this A/B imbalance

A

Respiratory Acidosis

69
Q

Kyphoscoliosis

Obesity

Polio,ALS, MS

Lead to this A/B imbalance

A

Respiratory Acidosis

70
Q

Confusion

Lower LOC

Restlessness

Hypoventilation

Lead to this A/B imbalance

A

Respiratory Acidosis

71
Q

Vomiting

NG tube loss

Diuretic therapy

Lead to this A/B imbalance

A

Metabolic Alkalosis

72
Q

Irritated

Confused

Paresthesia, fingers, toes, mouth

Tetany

Muscle cramps

Seizures

Lead to this A/B imbalance

A

Metabolic Alkalosis

73
Q

High altitude

Anemia

Pneumia

Chf

Anxiety, fear, pain

This A/B imbalance

A

Respiratory Alkalosis

74
Q

salicylates are…

A

Asprins

75
Q

Carbonic anhydrases (CAs) catalyze a reaction fundamental for life:

Describe…

A

the bidirectional conversion of carbon dioxide (CO2) and water (H2O) into bicarbonate (HCO3−) and protons (H+).

76
Q

Where does the carbonic anhydrase reaction take place?

A

RBC in arterial blood

77
Q

HCO3- (known as ____) is the conjugate base of H2CO3 (known as ____) , a weak acid, and the conjugate acid of the carbonate ion

A

bicarbonate / carbonic acid

78
Q

What electrolyte issue is caused by acidosis

A

Acidosis
can cause hyperkalemia
. This is because acidosis causes potassium to shift from the intracellular to the extracellular compartment

79
Q

The kidneys treat acidosis by secreting more ______ into the urine

A

H+ ions

Effect= more HCO3 ions are reabsorbed in the blood

80
Q

The kidneys treat alkalosis by reabsorbing ______ into the blood

A

Absorb H+

Effect= more HCO3 ions are secreted in the urine

81
Q

Acidosis/ Alkalosis

Sleepy, SOB, Weakness, increased HR, Diarrhea

Hand tremor, numbness/ tingling, twitching,

Both have: Confusion, Coma, N/V

A

Acidosis
Sleepy, SOB, Weakness, increased HR, Diarrhea

Alkalosis
Hand tremor, numbness/ tingling, twitching,

82
Q

1 liter of fluid weighs …

A

1 kilo = 2.2 lbs

83
Q

Respiratory Alkalosis is associated with

Hypocalcemia/ Hypercalcemia

A

Hypocalcemia

S/S Increased muscle twitching

84
Q

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

A

Hypocalcemia = Muscle twitching

Hypercalcemia = Muscle weakness

85
Q

Hypocalcemia VALUE

Hypercalcemia VALUE

A

Hypo <8.5

Hyper >10.5

86
Q

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.

A

Metabolic acidosisincreases calcium in the blood

As pH increases,protein bindingincreases, which decreases free calcium levels.

87
Q

SaO² Normal value

PaO² Normal value

A

SaO² Normal value >95

PaO² Normal value 80 - 100

88
Q

(HCO3) acidic or basic?

A

Basic

Bicarbonate

89
Q

Most common symptom of Respiratory Acidosis

A

Hypoventilation with hypoxia (CO2 buildup)

Warm, Flushed Skin

90
Q

What happens to RBC, Hct, Hemoglobin levels with Dehydration

A

Increase

91
Q

Elevated Serum Osmolality
BUN

Elevated levels indicate

Fluid volume Overload or Depletion

A

Depletion

Dehydration

92
Q

Urine specific gravity range

What does outside normal mean

A

Excess Fluid 1.005–1.030 Dehydration

93
Q

Serum Osmolality normal

A

Fluid excess 275 and 295 Dehydration

94
Q

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

A confused

95
Q

what are the 2 electrolyte imbalances associated with acidosis

A

Hyperkalemia

Hypochloremia

96
Q

what are the 2 electrolyte imbalances associated with alkalosis

A

Hypokalemia

Hyperchloremia

97
Q

As pH goes, so does my patient, except for ____

Explain meaning

A

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
Q

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)

A

Metabolic Acidosis +

increased acid production (DKA, starvation, lactic acidosis, shock)

99
Q

Salicylate poisoning causes…

Alkalosis or Acidosis

A

Both

respiratory alkalosis and, by an independent mechanism, metabolic acidosis

NURS 1355 (12 decks)

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