ABG practice (Exam 1) Flashcards
Respiratory Acidosis
pH is low then there is a decrease in the respiratory rate (too much CO2 retention)
Respiraotry Acidosis Cause
Resp arrest
Sedation
Medications
(Slow and shallow RR)
Respiratory acidosis ABG without compensations
pH - 7.25 (7.35-7.45)
PCO2 - 56 (35-45)
HCO3 - 24 (22-26) (normal = no compensation)
Respiratory acidosis fix
Help the patient breath to start blowing off CO2
Improve ventilation and increase Rate/Depth of breathing
Do not give sodium bicarb (no benefit)
Respiratory Acidosis Fully Compensated
pH will be normal if fully compensated
pH - 7.35 (7.35-7.45)
PCO2 - 56 (35-35)
HCO3 - 35 (22-26)
Patient with COPD
Respiratory Alkalosis
When there is an increase in RR there is an increase in pH
Respiratory Alkalosis Causes
Anxiety / rapid and shallow breathing
Resp Alkalosis uncompensated
pH - 7.6
PCO2- 25
HCO3 - 24
Resp Alkalosis Uncompensated Intervention
Takes measure retain CO2 like decrease respirations or breathing into paper bag
Calm patient - anxiety meds
Have patient inhale carbon dioxide or decrease RR to increase CO2 levels
Resp Alkalosis Full Compensated
pH - 7.45 Normal
PCO2 - 30 Low
HCO3 - 20 Low
Metabolic Acidosis
The event is metabolic so the LUNGS are compensating
pH is down which is low HCO3. Lungs compensate by increasing rate and depth to blow off CO2
Metabolic Acidosis Causes and Treatment
DKA = high ketones
Rapid acting insulin to bring BG down
Metabolic Acidosis Uncompensated
pH - 7.26 Low
PCO2 - 40 Normal
HCO3 - 18 Low
Metabolic Acidosis Fully Compensated
pH - 7.35 Normal
PCO2 - 33 Low
HCO3 - 20 Low
Metabolic Alkalosis
pH is increase and metabolic alkalosis is present as indicated by high HCO3. Lungs compensate by decrease rate and depth of breathing to hold onto CO2
Metabolic Alkalosis Cause
Prolonged vomiting (loss of hydrogen)
Metabolic Alkalosis Uncompensated
pH - 7.46 High
PCO2 - 37 Normal
HCO3 - 30 High
Metabolic Alkalosis Treatment
Treat the causes
Give drugs to reduce gastric hydrochloric acid secretion (H2 blockers) and PPI’s
Metabolic Alkalosis Fully Compensated
pH - 7.45 Normal
PCO2 - 49 High
HCO3 - 30 High
With compensation
Compensating arrow will always move in the same direction as the disorder with a normal pH
Step 1 Interpreting ABG
Look at pH and determine if it is ACID or BASE
If normal and other parameters are not = COMPENSATION
Look at the way the pH is leaning:
- If leaning toward acid pH = less than 7.40
- If leaning toward alkalotic pH = greater than 7.40
Step 2 interpreting ABG
Look at PCO2
If PCO2 is abnormal and opposite of pH = respiratory problem
Step 3 interpreting ABG
Look at HCO3
If abnormal and same direction as pH = Metabolic problem
Step 4 interpreting ABG: Compensation 4 Levels
Uncompensated
-pH abnormal - acid OR base abnormal
Partially compensated
-pH abnormal - acid AND base component abnormal
Fully compensated
-pH normal - acid or base is neutralized but not corrected. acid or base components are abnormal but balance and moving in the same direction
Corrected
-All values with return to normal
