ABG and ARF

Question 1

What is the normal anion gap?

Answer 1

5-15 mEq/L

Question 2

List problems associated with increased anion gap.

Answer 2

• Ketoacidosis
• Uremia
• Salicylate intoxication
• Methanol
• Alcoholic ketosis
• Unmeasured osmoles: ethylene glycol, paraldehyde
• Lactic acidosis

Question 3

List problems associated with a normal anion gap

Answer 3

• saline infusion
• TPN
• diarrhea
• Ammonium chloride
• Acute renal failure, sometimes chronic

Question 4

Describe an uncompensated ABG

Answer 4

• abnormal pH

- HCO3 or CO2 will be normal

Question 5

Describe a partial compensated ABG

Answer 5

• abnormal pH

- HCO3 or CO2 will be slightly abnormal to compensate for the disorder

Question 6

Define acute respiratory failure

Answer 6

a rapidly occurring inability of the lungs to maintain adequate oxygenation of the blood with or without the impairment of CO2 elimination

Question 7

What is the general clinical picture of a patient with acute respiratory failure?

Answer 7

• PaO2 of 60 mmHg or less and/or
• PaCO2 of 50 mmHg or more AND
• pH < 7.30

Question 8

What are the pulmonary s/s of hypoxemic resp failure ?

Answer 8

• tachypnea
• adventitious lung sounds
• accessory muscle use

Question 9

What are the cardiac s/s of hypoxemic resp failure?

Answer 9

• tachyarrhythmias (initial)
• bradyarrhythmias (late)
• HTN
• Hypotension
• cyanosis (central - earlobe or lips)

Question 10

What are the nurological s/s of hypoxemix resp failure?

Answer 10

• anxiety

- agitation

Question 11

What are the pulmonary s/s of hypercapneic resp failure?

Answer 11

• bradypnea
• shallow breathing
• lung sounds that are clear or adventitious

Question 12

What are the neurological s/s of hypercapneic resp failure?

Answer 12

• progressive decreased LOC : lethargic, obtunded, stuporous, unresponsive