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Pharm Block 4 Mod 2 ABG's > ABG's > Flashcards

ABG's Flashcards

1
Q

Purpose of ABG

A

To access acid-base status and to determine adequacy of oxygenation and ventilation

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2
Q

Normal Values: pH

A
  1. 35-7.45

- balance of H+ ions

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3
Q

Normal Values: pCO2/Co2

A

35-45 mmHg

  • respiratory parameter
  • carbonic acid HCO3 dissolves into CO2 + H2O
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4
Q

Normal Values: HCO3-

A

22-26

  • metabolic parameter
  • This is CALCULATED on the ABG
  • Measured HCO3- is reported as CO2 on a chemistry panel
  • Serum CO2
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5
Q

Normal Values: O2

A

95-100%

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6
Q

Normal Values: pO2

A

80-100

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7
Q

Primary Event

A

The PROBLEM that initiates the acid-base imbalance

-Hypoventilation, Hyperventilation, vomiting, diarrhea….

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8
Q

Primary Disorder

A

What RESULTS from the primary event

-Respiratory acidosis, metabolic alkalosis ect…

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9
Q

Compensation mechanisms

A

Physiologic process that adjust the pH back to normal range

  • If lungs are problem – kidneys will compensate
  • If kidneys are problem – lungs will compensate
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10
Q

General CAUSE of imbalance is termed: “METABOLIC”

A
  • HCO3 (Bicarb) level changes secondary to METABOLIC alterations (kidneys)
  • The PROBLEM is metabolic in nature
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11
Q

General CAUSE of imbalance is termed: “RESPIRATORY”

A
  • H2CO3 (carbonic acid) levels changes secondary to RESPIRATORY alterations (lungs)
  • The PROBLEM is respiratory in nature.
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12
Q

Types of Imbalances: Respiratory acidosis + Respiratory alkalosis

A

Increase or decrease in CO2 changes in ventilation

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13
Q

Types of Imbalances: Metabolic acidosis

Metabolic alkalosis

A

Changes in [H+] or bicarbonate ions

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14
Q

PaCO2

A

Acid (carbon dioxide)

-Respiratory

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15
Q

HCO3

A

Base (bicarbonate)

-Metabolic (kidney)

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16
Q

Causes of Metabolic Alkalosis

A
  1. Too much baking soda (alka-seltzer)
    - results in hypokalemia causing hydrogen to shift out of the intracellular space and K+ goes into the cell
  2. Prolonged vomiting
  3. NG tube
  4. Diuretics
17
Q

Metabolic Alkalosis: S/S

A 
-CNS over-excitability causing: 
(restlessness)
-Confusion
-Tremors
-Muscle cramps
-Paresthesia's (tingling of fingers and toes)
-Coma
-N/V/D
-Respiratory depression
-Dysrhythmias (Tachycardia)
-Hypokalemia 
-Compensatory Hypoventilation
18
Q

Metabolic Alkalosis can be caused by

A

too much Bicarb (HCO3) or not enough Carbonic Acid (H2CO3)

ABG’s
pH: high
PaCO2: 35-45 (same)
HCO3 > 26 (high)

19
Q

H2CO3 (carbonic acid) = CO2 + H2O

A

Might see H2CO3 or CO2

20
Q

Respiratory Alkalosis can be caused by

A

H2CO3 deficit in ECF

Primary cause: Hyperventilation (CO2 blown off)

ABGs
pH: high
PaCO2: <35 (low)
HCO3: 22-26 (same)

21
Q

Respiratory Alkalosis: Causes

A
  • Hyperventilation
  • Increased metabolic demands (fever, sepsis)
  • Medications
  • Acute anxiety
  • Hypoxia
  • PE or lung disease
  • CNS lesions
  • Ventilator settings
22
Q

Respiratory Alkalosis: S/S

A 
CNS Over-excitability causing:
-tachypnea
-Light headedness
-Confusion, blurred vision
-Paresthesia
-Hyperactive reflexes
-Coma 
-Hypokalemia
-Tachycardia
-N/V
(similar to metabolic alkalosis)
23
Q

Respiratory Acidosis: Acute or Chronic

A

H2CO3 excess in ECF (too much acid/H+)

Hypoventilation (CO2 remains)

Acute: respiratory arrest
Chronic: COPD or over sedation

pH: Low
PaCO2: >45
HCO3: 22-26 (same)

HCO3 (bicarb) WNL if acute respiratory acidosis, NO time for kidneys to compensate

HCO3 will be high if Chronic (COPD)

24
Q

Respiratory Acidosis: causes

A
  • Cardiopulmonary arrest
  • head injury
  • Narcotics/sedatives
  • Anesthesia (paralyze lungs)
  • Pulmonary disorders (acute asthma, COPD, PNA, resp failure)
  • Pain
  • Abdominal distension
  • Airway obstruction
  • Chest wall deformities
  • Neuromuscular problems

**All caused by Hypoventilation

25
Q

Respiratory Acidosis: S/S

A

CNS Depression causing

  • Hypoventilation
  • Dyspnea
  • Respiratory distress
  • Shallow respirations
  • H/A, restlessness, confusion
  • tachy, arrhythmias
  • Dec LOC, Stupor, Coma
  • Dec BP
26
Q

Metabolic Acidosis

A

HCO3 (Bicarb) Deficit in ECF
-Excess acids are added or bicarb is lost

ABGs
pH: Low
PaCO2: 35-45 (same)
HCO3: <22

27
Q

Metabolic Acidosis: Causes

A
  • renal failure
  • Fistulas (loss of Bicarb)
  • Diabetes (type 1 DM-DKA)
  • Lactic acidosis
  • Prolonged diarrhea (relative increased acid d/t loss of HCO3)
  • Starvation (body using fat for energy resulting in ketosis)
  • Shock and cardiac arrest
28
Q

Metabolic Acidosis: S/S

A

CNS

  • lethargy
  • Confusion
  • tremors, muscle cramps
  • paresthesia’s
  • Hypotension
  • Hyperkalemia
  • Deep breathing (KUSSMAUL respirations) DKA
29
Q

Respiratory Acidosis/Alkalosis Compensation

A

Are the results of respiratory alterations and the KIDNEY compensates by either

  1. Conserving (reabsorbing) HCO3
  2. Excreting HCO3

-takes hours to days for kidneys to compensate

30
Q

Metabolic Acidosis/Alkalosis Compensation

A

Are the results of metabolic alterations and the LUNGs compensate by either

  1. Conserving CO2 ions (hypoventilation)
  2. Excreting CO2 ions (hyperventilation)

-The kidney also attempts to correct imbalance by retaining/excreting HCO3

Pharm Block 4 Mod 2 ABG's (4 decks)

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