ABGs and Lines Flashcards
What does PO2 measure
free unbound O2
PO2 is the driving force for…
Hb saturation with O2
PO2 is determined by
- Alveolar ventilation
- V/Q
- FiO2
What are ABGs a measure of
partial pressure and pH of O2 and CO2 in the blood
PCO2 is controlled by ____
ventilation
HCO3- is regulated by
Renal
CO2 is regulated by
respiratory
Normal range for pH
7.35-7.45
Normal range for PaCO2
35-45
Normal range for HCO3-
22-28
Normal range for PaO2
80-100mmHg
Normal range for SaO2
95-100%
metabolic and respiratory acidosis =
pH is lower than normal
metabolic and respiratory alkalosis
pH is higher than normal
Respiratory acidosis =
pH Declined
PaCO2 increase
HCO3 normal
Respiratory alkalosis =
pH increase
PaCO2 decrease
HCO3 normal
Metabolic acidosis =
pH decreased
PaCO2 normal
HCO3 decreased
metabolic alkalosis =
pH increased
PaCO2 normal
HCO3 increase
6 rules for examining ABGs
- look at pH first to see what primary process it is (acidosis or alkalosis)
- remember clinical context (respiratory or metabolic condition)
- respiratory compensation can take minutes to hours
- renal compensation can take 1-5 days to occur
- compensation can be partial or total
- for alveolar hypoventilation the PO2 should only decrease 1 mmHg for every 1 mmHg increase in PaCO2
What is an ART line? where might it be inserted?
constantly monitor arterial BP
- may be inserted into radial, axillary, femoral or pedal artery
Precautions with ART lines
- infusion bag must be kept above insertion site
- notify RN if transducer disconnected
- ROM restrictions (ie. no hip flexion past 90° with femoral ART line)
What is a PICC line? Where might it be inserted?
to deliver chemotherapy or antibiotics (often simultaneously)
- inserted into large vein of the arm near bend of elbow and pushed until tip sits above heart
Precautions with a PICC line
do not mobilize until proper insertion confirmed with x-ray
What is an ECG line
Measures Electrical activity of heart
What are the contraindications with an ECG line
sternotomy – limitations in lifting (10 lb. above waist, no pushing STS, and no pull/push over 5 lbs.)
What is a patient controlled analgesic
self-administered meds, will preset how much they can get
Precautions with a patient controlled analgesic
look for BP drop, RR less than 10, altered mental status
Precautions with epidural
- careful with movements of trunk, hips, LE – can be very uncomfortable
- always check orders
- if dislodged get help immediately
Precautions/contraindications with NG Tube
- Feed is kept above site of insertion, need feeds turned off before start of therapy, HEAD OF BED NOT FLAT FEED WILL FLOW BACK (keep at least 30 degrees incline)!
Precautions/contraindications with chest tube
Keep below site of insertion to prevent backflow
Precautions/contraindication with urinary catheter
Foley - keep below site of insertion to prevent backflow
