abg and o2 analyzers Flashcards
how accurate are oxygen analyzers
+/- 2%
invasive procedures
require insertion of a sensor or collection device into the body
noninvasive
gathers data externally
Clark electrode
polarizing voltage causes an electron flow between the anode and cathode, platinum catheter and silver chloride and uses oxygen to produce a production oxidation reaction
percutaneous arterial puncture site
radial
brachial
femoral
dorsalis pedis
indications for ABG
sudden, unexplained dyspnea
cyanosis
abnormal breath sounds
severe and unexplained tachypnea
heavy use of accessory muscles
changes in ventilator settings
cardiopulmonary resuscitation
new appearance in diffuse infiltrates in chest radiograph
sudden appearance or progression in cardiac arrhythmias
acute hypotension
acute deterioration in neurologic function
quality control on blood gas machine
every 8 hours
PPE precaution for ABG
hand washing
gloves
eye ware
checking chart for ABG
confirm order and indications determine patient primary diagnosis history - bleeding disorder - blood-borne infections current status respiratory care orders - O2 therapy - mechanical vent anticoagulant or thrombolytic therapy
modified allen test
release ulna
getting a good sample
never redirect a needle without withdrawing
if withdrawn completely you must get a fresh blood gas kit
anxiety during ABG
hyperventilation and breath holding
increases or decreasing CO2
Avoiding ABG error
chill sample if not read within 15 minutes
use low diffusibiliy syringe with heprin
check for air bubbles
pre-analytic erros
air in sample
venous admixture
excess anticoagulant
metabolic effects
altered values with air bubbles
oxygen can increase or decrease
carbon dioxide will decrease
pH will increase
calibration
two point calibration usually a high and low value range ? 1-10? systemic error - component failure random error - sample error
transcutaneous monitoring
patients in deep sedation or mechanical vent
infants/ children with hypoxemia
checks gas exchange at bedside
alternate puncture site
inaccessible artery
absent pulse
deficient sample return
how long should you wait to obtain ABG with changes to oxygenation
COPD 30 min
healthy 5 min
assessment before ABG
results of modified allens test body temperature patient positive activity level RR
venous admixture in ABG
greatly lower oxygen
increase CO2
decrease pH
pulse Ox Alarm
88%
pulse Ox unreliable
80%
troubleshoot capnography
disconnected rebreathing leaks check patient check wave forms
