ABGs Flashcards
Normal pH
7.35-7.45
normal Pao2
75-100
normal paCo2
35-45
normal hco3
22-28
normal sao2
94-100
normal arterial vol
15-22%
normal venous vol
11-16%
critical pH values
<7.25, >7.6
Critical PaCo2
<20, >60
critical HC03
<10, >40
Critical PaO2
<40
O2 sat critical
<75%
What should you perform prior to ABG?
allen’s test
PaCO2 is elevated in
respiratory acidosis
metabolic alkalosis
PaCO2 is decreased in
respiratory alkalosis
metabolic acidosis
Majority of the CO2 in the blood is
HCO3 - regulated by the kidneys
elevated in metabolic alkalosis, decreased in metabolic acidosis
indirect measure of O2 in arterial blood
PaO2
decreased in: oxygen diffusion issues, premature mixing of arterial/venous blood (CHD), overperfusion (Pickwickian syndrome)
% of hemoglobin saturated w/ oxygen
O2 saturation
if carbon monoxide poisoning –> put O2 on
amount of oxygen in the blood
O2 sat * Hgb * 1.34 * PO2 * .003
base excess/deficit calculated by
pH, PaCO2, Hct, measuring amount of buffering anions
negative = metabolic acidosis
positive = metabolic alkalosis or compenstaed resp acidosis
When to draw an ABG?
resp failure, acid-base disorders, monitoring critically ill patients, evaluation of organ function, guiding therapy decisions
interpret ABG
1) check pH
2) analyze paCO2
3) analyze HC03
4_ compensatory mechanisms
high PaCO2, low pH
respiratory acidosis from COPD, asthma, overdose
low PaCO2, high pH
respiratory alkalosis from hyperventilation, anxiety, pain
low HCO3, low pH
metabolic acidosis from diabetic ketoacidosis, renal failure
high HCO3, high pH
metabolic alkalosis, vomiting, diuretic use
CIs to ABG
absence of pulse, infection, - allen test, AV fistula proximal to site of acess, severe coaguloopathy
can cause arterial occlusion, nerve injury
metabolic alkalosis can be from
hypokalemia
hypochloremia
chronic + high vol gastric suction
chronic vomiting
aldosteronism
respiratory alkalosis can be from
CHF, cystic fibrosis, CO poisoning, anxiety, pain, preganncy
metabolic acidosis can be from
keto acidosis, lactic acidosis, severe diarrhea, renal failure
respiratory acidosis can be from
resp failure
Tx: respiratory acidosis
improve ventilation
Tx: respiratory alkalosis
treat underlying cause
Tx: metabolic acidosis
treat underlying cause
Tx: metabolic alkalosis
correct electrolyte imbalances, treat vomiting
COPD
oversedation
head trauma
over-oxygenation in patients w/ COPD causes
increased PaCO2
hypoxemia
PE
anxiety
pain
pregnancy
decreased PaCO2
chronic vomiting
aldosteronism
use of mercurial diuretics
COPD
increased HC03
chronic or severe diarrhea
chronic use of loop diuretics
starvation
DKA
AKI
decreased HCO3
polycythemia
increased oxygen
hyperventilation
increased PaO2 + O2 content
anemias
mucus plug
bronchospasm
pneumothorax
pulmonary edema
ARDS
decreased PaO2 + O2 content
anion gap
10-16
high anion gap
lactate, ketones, renal, toxins
normal anion gap
chloride, acetazolamide, addisons
GI causes - diarrhea ,vomtiing, fistulas