ABGs Flashcards
1
Q
Base Excess
A
+/-2
mirrored by bicarb
encompasses all metabolic bases.
2
Q
Buffering system
A
CO2 + H2O —H2CO3—HCO3 +H
lungs — cabonic acid– kidneys
= equilibrium
3
Q
metabolic acidosis
A
pH <22
not enough acid removed by kidneys
not enough bicarb reabsorbed by kidneys
4
Q
Types of metabolic acidosis
A
high anion gap
normal anion gap
5
Q
Anion Gap
A
- difference btw commonly measures cations and anions
- Na - (Cl +bicarb)
identifies possible causes of metabolic acidosis
Normal 8-16
6
Q
high Anion gap
A
Increased Acids
7
Q
Normal Anion gap
A
decreased bases - loss of bicarb
8
Q
unmeasured or “missing anions”: acids
A
lactate acetoacetate sulphate ketones other organic acids
9
Q
Causes of high anion gap
A
- tissue hypoxia**
- hyperglycemia
- chronic renal failure
- intoxification: ASA, methanol, ethylene
10
Q
Normal anion gap
A
- diarrhea - bicarb loss
- pancreatic fistula
uretero- sigmoidoscopy
glue sniffing
11
Q
Signs and symptoms of acidosis
A
HA Altered LOC lethargy ventricular arrythmias - K hypotension decreased response to catecholimines
12
Q
Metabolic Alkalosis
A
pH >7.45
Bicarb >26
13
Q
Metabolic alkalosis - chloride responsive
A
vomiting- loss of H+, cl, and H2o - bicard is reabsorbed to replace Cl - alkalotic DT H+ loss and bicard reabsorbed kidneys maintain to keep Cl - urine Cl <10 mEq/l responds to Sodium chloride infusion - chloride replaces bicarb kidneys excrete bicard
14
Q
Metabolic alkalosis: chloride resistant
A
- common in elderly
- chronic prednisone
- primary aldosteronism
- excess mineralchloride: stimulates Na H+ exchange, excessive renal generation of bicarb
15
Q
Signs and symptoms of alkalosis
A
resp compensation? hypoventilate
electrolytes
HA
seizures
