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Patho II Exam 1 > ABGs > Flashcards

ABGs Flashcards

1
Q

purpose of ABGs

A

to assess acid-base status and to determine adequacy of oxygenation and ventilation

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2
Q

pH normal range and purpose

A

–7.35-7.45
–balance of H+

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3
Q

PaCO2 normal range and purpose

A

–35-45
–respiratory parameter
–carbonic acid dissolves into CO2 and H2O

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4
Q

HCO3 normal range and purpose

A

–22-26
–metabolic parameter
–measured HCO3 is reported as CO2 on a chem panel

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5
Q

PaCO2

A

partial pressure of CO2 in artery

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6
Q

components of ABG

A

–pH (7.35-7.45)
–PaCO2
–HCO3

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7
Q

components of VBG

A

–pH (7.31-7.41)
–PvCO2 (41-51)
–HCO3

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8
Q

PvCO2

A

partial pressure of CO2 in vein

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9
Q

BMP

A

serum CO2 = HCO3 level (22-26)

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10
Q

primary event

A

the problem that initiates the acid-base imbalance (hypoventilation, hyperventilation, vomiting, diarrhea, etc.)

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11
Q

primary disorder

A

what results from the primary event (respiratory acidosis, metabolic alkalosis, etc.)

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12
Q

compensation mechanisms

A

physiologic processes that adjust the pH back to the normal range
–lungs are problem = kidneys compensate
–kidneys are problems = lungs compensate

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13
Q

metabolic cause of imbalance

A

–HCO3 level changes secondary to metabolic alterations
–the PROBLEM is metabolic in nature

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14
Q

respiratory cause of imbalance

A

–H2CO3 level changes secondary to respiratory alterations
–the PROBLEM is respiratory in nature

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15
Q

respiratory acidosis and alkalosis

A

–increase or decrease in CO2
–changes in ventilation

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16
Q

metabolic acidosis and alkalosis

A

changes in H+ or bicarb ions

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17
Q

acid base pneumonic

A

R(espiratory)
O(pposite)
M(etabolic)
E(qual)

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18
Q

‘Respiratory Opposite’

A

–pH high, CO2 low (alkalosis)
–pH low, CO2 high (acidosis)

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19
Q

‘Metabolic Equal’

A

–pH high, HCO3 high (alkalosis)
–pH low, HCO3 low (acidotic)

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20
Q

metabolic alkalosis

A

too much bicarb or not enough carbonic acid

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21
Q

ABGs for metabolic alkalosis

A

pH > 7.45
PaCO2 : 35-45
HCO3 > 26

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22
Q

causes of metabolic alkalosis

A

–taking excess baking soda or alka-seltzer = too much base
–prolonged vomiting
–NG tube
–diuretics

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23
Q

effect of taking too much baking soda or antacids

A

hypokalemia causing hydrogen to shift out of the intracellular space and potassium goes into the cell

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24
Q

symptoms of metabolic alkalosis

A

–CNS over-excitability
–confusion
–tremors
–muscle cramps
–paresthesias
–coma
–N/V/D
–respiratory depression
–hypoventilation (compensatory)
–tachycardia
–hypokalemia

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25
Q

respiratory alkalosis

A

–H2CO3 deficit in ECF
–hyperventilation –> primary event –> CO2 blown off

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26
Q

ABGs for respiratory alkalosis

A

–pH > 7.45
–PaCO2 < 35
–HCO3 = 22-26

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27
Q

common causes of respiratory alkalosis

A

–hyperventilation
–increased metabolic demands
–meds
–acute anxiety
–hypoxia
–PE or lung disease
–CNS lesions
–vent settings

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28
Q

symptoms of respiratory alkalosis

A

–tachypnea
–light headedness
–confusion, blurred vision
–paresthesia
–hyperactive reflexes (seizures)
–coma

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29
Q

respiratory acidosis

A

H2CO3 in excess

30
Q

primary event in respiratory acidosis

A

hypoventilation

31
Q

primary event for respiratory alkalosis

A

hyperventilation

32
Q

ABGs for respiratory acidosis

A

–pH < 7.35
–PaCO2 > 45
–HCO3 = 22-26

33
Q

when is HCO3 WNL for respiratory acidosis?

A

acute respiratory acidosis
no time for kidneys to compensate

34
Q

signs of respiratory acidosis

A

–hypoventilation
–dyspnea
–respiratory distress
–shallow respirations
–headache, restlessness, confusion
–tachycardia, arrythmias
–decreased LOC, stupor, coma

35
Q

common causes of respiratory acidosis

A

–cardiopulmonary arrest
–head injury
–narcotics/sedatives
–anesthesia
–pulmonary disorders
–pain
–abdominal distention
–airway obstruction
–chest wall deformities
–neuromuscular problems (ALS)

36
Q

metabolic acidosis

A

HCO3 deficit in ECF
–excess acids are added or bicarb is lost

37
Q

ABGs for metabolic acidosis

A

–pH < 7.35
–PaCO2 = 35-45
–HCO3 < 22

38
Q

CO2 and compensation with metabolic acidosis

A

if lungs are compensating, the CO2 will be decreased

39
Q

symptoms of metabolic acidosis

A

–lethargy, drowsiness
–confusion
–tremors, muscle cramps
–paresthesias
–hypotension
–hyperkalemia
–deep breathing (Kussmaul’s respirations)
–fruity odor breath (DKA)

40
Q

common causes of metabolic acidosis

A

–renal failure
–fistulas
–diabetes (Type 1)
–lactic acidosis
–prolonged diarrhea
–starvation
–medication overdose (aspirin)
–shock and cardiac arrest

41
Q

respiratory acidosis/alkalosis compensation

A

kidneys compensate by either:
(1) conserving (reabsorbing) HCO3
(2) excreting HCO3
**hours to days

42
Q

metabolic acidosis/alkalosis compensation

A

lungs compensate by either:
(1) conserving CO2 ions
(2) excreting CO2 ions
**kidneys also attempt to correct imbalance by retaining/excreting HCO3
**minutes to hours

43
Q

rate of compensation with respiratory

A

rapid

44
Q

rate of compensation with metabolic

A

slow

45
Q

major organ involved in respiratory compensation

A

lungs

46
Q

major organ involved in metabolic compensation

A

kidneys

47
Q

compensatory mechanism of lungs

A

hyper/hypoventilation

48
Q

compensatory mechanism of kidneys

A

retention/excretion of H+/HCO3

49
Q

acid-base problem triggering activation of compensation in respiratory

A

metabolic A-B abnormalities

50
Q

acid-base problem triggering activation of compensation in metabolic

A

respiratory A-B abnormalities

51
Q

interventions for respiratory acidosis

A

measures to improve ventilation
–increase rate/depth of RR
–stimulate patient/encourage slow and deep respirations
–give sodium bicarb

52
Q

fully compensated respiratory acidosis

A

–pH normal, leaning acidic
–PaCO2 high
–HCO3 high

53
Q

uncompensated respiratory alkalosis

A

pH high
PaCO2 low
HCO3 WNL

54
Q

interventions for respiratory alkalosis

A

–calm patient
–breathe into paper bag
–anti-anxiety meds
–rebreather

55
Q

fully compensated respiratory alkalosis

A

pH normal, leaning basic
PaCO2 low
HCO3 low

56
Q

metabolic acidosis physiology

A

–pH is down and metabolic acidosis presents as low HCO3
–lungs compensate by increasing the rate and depth of respirations to blow off CO2, moving pH back toward a more normal state

57
Q

treatment for metabolic acidosis

A

admin rapid acting insulin to bring BG down

58
Q

uncompensated metabolic acidosis

A

pH low
PaCO2 normal
HCO3 low

59
Q

partially compensated metabolic acidosis

A

pH low
PaCO2 low
HCO3 low

60
Q

fully compensated metabolic acidosis

A

pH normal (leaning acidic)
PaCO2 low
HCO3 low

61
Q

physiology of metabolic alkalosis

A

–pH is increased and metabolic alkalosis is present as indicated by high HCO3
–lungs compensate by decreasing rate and depth of respirations to hold on to CO2

62
Q

uncompensated metabolic alkalosis

A

pH high
PaCO2 normal
HCO3 high

63
Q

partially compensated metabolic acidosis

A

pH low
PaCO2 low
HCO3 low

64
Q

fully compensated metabolic acidosis

A

pH normal (leaning low)
PaCO2 low
HCO3 low

65
Q

pH “leaning toward acid”

A

pH < 7.4

66
Q

pH “leaning toward base”

A

pH > 7.4

67
Q

uncompensated

A

–pH abnormal
–acid OR base abnormal

68
Q

partially compensated

A

–pH abnormal
–acid AND base abnormal

69
Q

fully compensated

A

–pH normal (leaning acid or base)
–acid or base abnormal, but balanced (arrows moving in same direction)

70
Q

corrected

A

–pH WNL
–all acid or base parameters WNL

71
Q

COPD patient balance

A

compensated, but not corrected

Patho II Exam 1 (5 decks)

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