ABG Flashcards
Normal blood pH
7.4
Difference in sums of strong (or abundant) cations and anions. Should approximate Bicarb
Stewart’s strong ion difference
If you infuse person with acid
They start breathing more deeply and more rapidly, kussmal breathing
Protein metabolism produces
Phosphorus and sulfur
PCO2, PO2, and pH
Directly measured
O2 sat and Bicarb
Calculated
Renal compensation takes up to
72 hrs
Multiple acid/base problems in same person.
Diabetic ketoacidosis
Ketones make
Acidosis
Throwing up cause
Alkalosis
Normal anion gap
4-12
_______ anion gap suggests presence of unmeasured anion that shouldn’t be there
High
Due to accumulation of ketones or lactic acid. Poisoning with ethylene glycol
High anion gap
Sedatives and neurological disorders can prevent
Reflexive compensation
Determined by levels of carbonic acid and Bicarb in plasma
Blood pH
Treat with insulin and fluids
Ketoacidosis
Product of cellular metabolism
CO2
Product of protein catabolism
Titrable acid
Excretes titrable acid
Kidney
H secretion into collecting duct (in presence of aldosterone) with proton trapping in urine
Kidneys. Titrable acid.
Blows off volatile CO2
Lungs
Cannot compensate for massive acid load
Kidneys
Fall in pH activates ______ and ______ causing increased respiratory rate and tidal volume
Peripheral arterial and central chemoreceptors
Occurs in seconds and can respond to large acid load
Pulmonary compensation
Acidemia from accumulation of titrable acid will affect ___ and trigger ______
CO2. Pulmonary response.
Addition of acidic substance that can’t be excreted
Metabolic acidosis
Hypoventilation
Respiratory acidosis
Hyperventilation
Respiratory alkalosis
Anion gap only seen with
Metabolic acidosis
Lactic acidosis, ketoacidosis, loss of Bicarb, ingested toxins
Metabolic acidosis
Loss of Bicarb
Metabolic acidosis
Diabetic, alcohol, starvation
Ketoacidosis
Diarrhea and renal failure can cause
Loss of Bicarb
Ethylene glycol, methanol, Salicylates
Metabolic acidosis
Non anion gap metabolic acidosis due to Bicarb loss usually caused by
Renal failure or diarrhea
Anion gap elevation should be similar to decrease in
Bicarb