ABG Crap Flashcards

1
Q

What value determines how well patient is oxygenated?

A

PaO2

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2
Q

What value determines how well patient is ventilating?

A

PaCO2

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3
Q

3 systems and mechanisms that control acid/base

A

Kidney-HCO3

Lungs-CO2

Buffer-electrolytes

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4
Q

CO2 is acid or base?

A

Acid

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5
Q

HCO3 is acid or base?

A

Base

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6
Q

CO2 is only found in the __________ system

A

Respiratory

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7
Q

What value measures the concentration of hydrogen ions (H+) in arterial blood?

A

pH

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8
Q

As concentration of H+ rises, pH _______

A

lowers

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9
Q

As concentration of H+ lowers, pH ________

A

rises

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10
Q

What represents partial pressure of O2 dissolved in arterial blood?

A

PaO2

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11
Q

PaO2 less than 60 indicates what?

A

hypoxia

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12
Q

3 sites ABG is drawn

A

Radial artery (Most common)

Brachial artery

Femoral artery (Last resort)

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13
Q

Test used before radial ABG draw

A

Allen’s test

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14
Q

What color should blood be from artery?

A

Bright red

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15
Q

Flashback of artery blood should ______ into the syringe

A

pulsate

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16
Q

How many mL will blood stop in syringe?

A

2 mL

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17
Q

Apply pressure for how many minutes after ABG draw?

A

5-10 minutes

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18
Q

If patient is on anticoagulants, how many minutes should you apply pressure?

A

10-15 minutes

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19
Q

Arterial line complications

A
  • hemorrhage
  • infection
  • thrombus formation
  • neurovascular impairment
  • loss of limb
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20
Q

Normal arterial blood pH range

A

7.35-7.45

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21
Q

pH less than 7.35 is

A

Acidic

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22
Q

pH greater than 7.45

A

Alkalotic

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23
Q

Normal PaCO2 range

A

35-45

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24
Q

Respiratory parameter

A

PaCO2

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25
Q

Metabolic parameter

A

HCO3

26
Q

Normal HCO3

A

22-26

27
Q

High PaCO2=

A

respiratory acidosis

28
Q

Low PaCO2=

A

respiratory alkalosis

29
Q

Hypoventilation

  • OD
  • chest trauma
  • pulmonary edema
  • airway obstruction
  • COPD
  • sedation
  • neuromuscular disease
  • phrenic nerve or C2 injury
A

Respiratory acidosis

30
Q

Hyperventilation

  • anxiety
  • high altitudes
  • pregnancy
  • fever
  • hypoxia
  • too much tidal volume (ventilator)
A

Respiratory alkalosis

31
Q

Low HCO3=

A

metabolic acidosis

32
Q

High HCO3=

A

metabolic alkalosis

33
Q
  • diabetic ketoacidosis
  • diarrhea
  • renal failure
  • shock
  • salicylate OD
  • sepsis
A

metabolic acidosis

34
Q

Why does diarrhea cause metabolic acidosis?

A

loss of bicarb

35
Q

Why does renal failure cause metabolic acidosis?

A

kidneys are not absorbing bicarb

36
Q

Why does shock, salicylate OD, and sepsis cause metabolic acidosis?

A

The body’s release of lactic acid and potassium (K+) causes the body to become acidic

37
Q

PaCO2 less than 35

A

Alkalotic

38
Q

PaCO2 greater than 45

A

Acidoic

39
Q

HCO3 less than 22

A

Acid

40
Q

HCO3 greater than 26

A

Alkaline

41
Q

PaO2

A

80-100

42
Q

Loss of gastric secretions (vomiting, NG suction)

Overuse of antacids

Potassium-wasting diuretics (Furosemide)

A

Metabolic alkalosis

43
Q

What is the ONLY normal pH value?

A

7.4

44
Q

Frequent ABG sampling
-daily AM draw if on vent

Continuous BP monitoring

  • shock
  • infusion of vasopressor
  • coronary intervention procedures
  • ACUTE hyper or hypotension
  • respiratory failure
  • neurological injuries
A

Indications for arterial lines

45
Q

pH is the measurement of __________ ions

A

Hydrogen (H+)

46
Q

When you think of CO2, think _________

A

Respiratory (in the lungs)

47
Q

When you think of HCO3, think _________

A

Metabolic (kidneys)

48
Q

Pt blowing off CO2 will have a _________ pH

A

high

49
Q

Pt holding on to CO2 will have a _________ pH

A

low

50
Q

Pt losing HCO3 will have a ________ pH

A

low

51
Q

Pt holding on to HCO3 will have a ________ pH

A

high

52
Q

What is the most common site for an ABG draw?

A

Radial artery

53
Q

What is the least common or “last resort” site for an ABG draw? Why?

A

Femoral; because it is linked to increased rates of hematoma and infection

54
Q

In what type of patient should you avoid a brachial ABG draw? Why?

A

Obese; because the artery will be harder to find due to excess adipose tissue in the area

55
Q

A PaO2 <60 indicates what?

A

hypoxia; PaO2 is the PRIMARY indication of hypoxic

56
Q

Indications of respiratory acidosis

A
Drug overdose
Chest trauma
Pulmonary edema
Airway obstruction
COPD
Sedation
Neuromuscular disease
57
Q

Indications of Respiratory Alkalosis

A
Anxiety
High altitude
Pregnancy
Fever
Hypoxia
Excessive tidal volume (vent)
58
Q

Indications of Metabolic Acidosis

A
Diabetic ketoacidosis
Diarrhea
Renal failure
Shock
Salicylate OD
Sepsis
59
Q

Indications of Metabolic Alkalosis

A

Loss of gastric secretions (NG suctioning)
Overuse of antacids
Potassium-wasting diuretics

60
Q

ABG practice:

pH - 7.26
PaCO2 - 42
HCO3 - 17

A

Uncompensated metabolic acidosis

61
Q

ABG Practice:

pH - 7.47
PaCO2 - 30
HCO3 - 23

A

Uncompensated respiratory alkalosis

62
Q

What are the rules to reading an ABG?

A
  1. What paired with the pH?
  2. Look at the pH - is pH in the normal range of 7.35-7.45?
    - If yes, write “compensated”
  3. If no, check to see if the other system is helping?
    - If yes, write “partially compensated”
    - If no, write “uncompensated”

ALWAYS WRITE THE VALUE FOR THE pH!! You always have to check to see if pH is in normal range or it can completely change the reading of the ABG.