ABG Review Flashcards
What ABG value indicates degree of ventilation?
CO2
What pH aberration decreases force of cardiac contraction, vascular response to catecholamines, and response to the effects and actions of certain meds?
acidosis
What pH aberration interferes with tissue oxygenation. affects rate of unloading of the oxygen from the hemoglobin
alkalosis
Senses concentrations of CO2, carbonic acid, and HCO3 and response initiates quick changes (within a 1-3 minutes) of body pH?
respiratory center
What are the two ways that minute ventilation can be changed?
respiratory rate and tidal volume
What are the three components of the chemical buffer system?
carbonic acid, phosphate, and proteins
What is the main buffering system?
carbonic acid
This response takes place over hours or even days, but represents a more powerful regulatory system of pH
renal buffer
Symptoms include: Dyspnea, respiratory distress and/or shallow respiration. HA, restlessness, confusion. Tachycardia and dysrhythmias
respiratory acidosis
What is the management of respiratory acidosis?
increase ventilation
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
respiratory alkalosis
What is the management of respiratory alkalosis?
monitor for respiratory muscle fatigue
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
metabolic acidosis
What breathing pattern is specific for metabolic acidosis?
Kussmaul’s respirations
What is the management of metabolic acidosis?
restore tissue perfusion and bicarb/hydration
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
metabolic alkalosis
Calculated value estimates the metabolic component of an acid base abnormality. Amount of excess or insufficient level of bicarbonate. -2 to +2mEq/L
base excess
What is the major anion of the ECF?
Cl-
What is the normal value for the anion gap (cations minus anions)?
10-16mmol/L
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?
respiratory acidosis
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?
intubate and ventilate
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?
anion gap metabolic acidosis
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?
respiratory acidosis secondary to narcotic overdosing
How does the respiratory system attempt to compensate for a decreasing arterial blood pH?
increased respiratory rate
What is the most powerful respiratory stimulus for breathing in a healthy person?
increased in CO2
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?
immediate intubation and ventilation