ABG Review

Question 1

What ABG value indicates degree of ventilation?

Answer 1

CO2

Question 2

What pH aberration decreases force of cardiac contraction, vascular response to catecholamines, and response to the effects and actions of certain meds?

Answer 2

acidosis

Question 3

What pH aberration interferes with tissue oxygenation. affects rate of unloading of the oxygen from the hemoglobin

Answer 3

alkalosis

Question 4

Senses concentrations of CO2, carbonic acid, and HCO3 and response initiates quick changes (within a 1-3 minutes) of body pH?

Answer 4

respiratory center

Question 5

What are the two ways that minute ventilation can be changed?

Answer 5

respiratory rate and tidal volume

Question 6

What are the three components of the chemical buffer system?

Answer 6

carbonic acid, phosphate, and proteins

Question 7

What is the main buffering system?

Answer 7

carbonic acid

Question 8

This response takes place over hours or even days, but represents a more powerful regulatory system of pH

Answer 8

renal buffer

Question 9

Symptoms include: Dyspnea, respiratory distress and/or shallow respiration. HA, restlessness, confusion. Tachycardia and dysrhythmias

Answer 9

respiratory acidosis

Question 10

What is the management of respiratory acidosis?

Answer 10

increase ventilation

Question 11

Can be caused by increased metabolic demands (fever, sepsis, pregnancy or thyrotoxicosis). Symptoms include light headedness, numbness, tingling, blurred vision. Dry mouth, diaphoresis, tetanic spasms of limbs

Answer 11

respiratory alkalosis

Question 12

What is the management of respiratory alkalosis?

Answer 12

monitor for respiratory muscle fatigue

Question 13

Can be caused by renal failure, DKA, anaerobic metabolism, starvation, ASA intoxication, sepsis. Symptoms include HA, confusion, restlessness progressing to stupor and coma. Warm, flushed skin. N/V

Answer 13

metabolic acidosis

Question 14

What breathing pattern is specific for metabolic acidosis?

Answer 14

Kussmaul’s respirations

Question 15

What is the management of metabolic acidosis?

Answer 15

restore tissue perfusion and bicarb/hydration

Question 16

Can be caused by excess antacids, protracted vomiting, gastric suction, exess diuretics or high levels of aldosterone. Symptoms include dizziness, lethargy, seizures, muscle weakness/twitching/cramps. N/V

Answer 16

metabolic alkalosis

Question 17

Calculated value estimates the metabolic component of an acid base abnormality. Amount of excess or insufficient level of bicarbonate. -2 to +2mEq/L

Answer 17

base excess

Question 18

What is the major anion of the ECF?

Answer 18

Cl-

Question 19

What is the normal value for the anion gap (cations minus anions)?

Answer 19

10-16mmol/L

Question 20

Patient is brought to ED in an unresponsive status. Initial stabilization has been started and you are handed a set of arterial blood gases on the patient. They reveal a pH of 7.12; pCO2 of 53; HCO3 of 20; and pO2 of 54. What is this patient’s primary acid-base problem?

Answer 20

respiratory acidosis

Question 21

You are treating an unconscious patient with an acute severe respiratory acidosis. What is the best initial approach in correcting this patient’s acid-base problem?

Answer 21

intubate and ventilate

Question 22

A 42 yo male was found unresponsive outside your emergency department. Initial vital signs revealed SaO2 91% on RA. Further labs revealed an ABG: pH 7.18; CO2 33; PO2 62; SaO2 90%. Na 144, Cl 99, HCO3 15, K 5. What is the primary acid-base disorder in this patient?

Answer 22

anion gap metabolic acidosis

Question 23

You are seeing a patient who has recently had a partial bowel resection and is experiencing decreased level of consciousness. The nurse hands you this ABG as you walk into the room to assess the patient. pH 7.25, CO2 65, PO2 65, HCO3 22. What is your interpretation of the blood gas and what is the most likely etiology?

Answer 23

respiratory acidosis secondary to narcotic overdosing

Question 24

How does the respiratory system attempt to compensate for a decreasing arterial blood pH?

Answer 24

increased respiratory rate

Question 25

What is the most powerful respiratory stimulus for breathing in a healthy person?

Answer 25

increased in CO2

Question 26

Patient had a Whipple procedure and received 6 units of blood intraoperatively. On the 4th post op day he developed rapidly worsening dyspnea and respiratory distress. Chest xray showed diffuse infiltrates. The patient’s blood gas on a nonrebreather mask shows: pH 7.2/CO 60/O2 50/HCO3 24. What is the BEST immediate treatment for this complication?

Answer 26

immediate intubation and ventilation