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ABSN > ABGs - patho 406 > Flashcards

ABGs - patho 406 Flashcards

1
Q

purpose of ABGs

A

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

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2
Q

primary event

A

the problem that initiates the acid base imbalance
(ex: hypovent, hypervent, vomiting, diarrhea)

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3
Q

primary disorder

A

what results from the primary event
(ex: resp acidosis, metabolic alkalosis)

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4
Q

compensation mechanisms

A

physiologic processes that adjust the pH back to the normal range
(ex: lung problem -> kidney will comp)

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5
Q

general causes of imbalance: metabolic

A

-HCO3 level changes secondary to metabolic alterations (kidneys)

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6
Q

general causes of imbalance: respiratory

A

-H2CO3 level changes secondary to respiratory alterations (lungs)

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7
Q

respiratory acidosis or alkalosis

A

increases or decrease in CO2
change in ventilation

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8
Q

metabolic acidosis or alkalosis

A

changes in H+ or bicarb ions

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9
Q

acid base mnemonic: ROME

A

R espiratory
O pposite
inc pH, dec PCO2 = alk; dec pH, inc PCO2 = acid

M etabolic
E qual
inc pH, inc HCO3 = alk; dec pH dec HCO3 = acid

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10
Q

metabolic acidosis: what is it & what is our comp

A

dec HCO3, dec Ph
comp: lungs blow off CO2 to decrease levels (dec pCO2)

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11
Q

respiratory alkalosis: what is it & what is our comp

A

dec CO2, inc pH
comp: kidneys get rid of bicard (HCO3) to decrease levels
(dec HCO3)

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12
Q

respiratory acidosis: what is it & what is our comp

A

inc pCO2, dec pH
comp: kidneys hold on to bicard to increase levels
(inc HCO3)

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13
Q

metabolic alkalosis: what is it & what is our comp

A

inc HCO3, inc pH
comp: lung hold on to CO2 to increase levels
(inc pCO2)

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14
Q

metabolic alkalosis: ABG

A

too much bicard or not enough carbonic acid
pH > 7.48 (B)
PaCO2: 35-45 (N)
HCO3 >29 (B)

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15
Q

metabolic alkalosis: causes

A

-taking excess baking soda, alka-seltzer (H shifts out of the cell & K+ goes in causing hypoK)
-prolonged vomiting
-NG tube suctioning
-diuretics (lose H but bicard stays)

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15
Q

metabolic alkalosis: clinical manifestations

A

CNS over excitability
confusion
tremors
muscle cramps
parethesias
coma
N/V/D
resp depression (to try to hold on to CO2)

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16
Q

respiratory alkalosis: ABGs

A

H2CO3 deficit in extracellular fluid
pH >7.45 (H/basic)
PaCO2 <35 (L)
HCO3-: 24-29 (N)

17
Q

respiratory alkalosis: causes

A

-hyperventilation (primary event)
kidneys need to comp but can’t work quickly so often time these pts pass out
-fever / sepsis (inc metabolic demand)
-medications
-acute anxiety
-hypoxia
-PE or lung disease
-CNS lesions
-ventilator

18
Q

respiratory alkalosis: clinical manifestations

A

-CNS over excitability
-tachypnea
-light headedness
-confusion, blurred vision
-paresthesia
-hyperactive reflexes
-coma

19
Q

respiratory acidosis: ABGs

A

H2CO3 excess in ECF
pH <7.35 (L/acidic)
PaCO2 > 45 (H)
HCO3-: 24-29 (N)
hco3 is wnl w/ acute resp acid bc kidneys don’t have time to comp -> if copd/chronic high bicard and normal pH d/t comp

20
Q

respiratory acidosis: clinical manifestation

A

-hypoventilation (primary event)
-dyspnea
-respiratory distress
-H/a, restlessness, confusion
-tachycardia, arrhythmias
-dec LOC, stupor, coma

21
Q

when a pt goes into respiratory arrest, they become

A

acidotic bc they are not breathing

22
Q

respiratory acidosis: causes

A

not taking good breaths or any
-hypoventilation
-cardiopulmonary arrest
-head injury
-narcotics/sedatives
-anesthesia
-pulmonary disorders
-pain (not taking deep breaths)
-abdominal distension
-airway obstruction
-chest wall deformities
-neuromuscular problems

23
Q

metabolic acidosis: ABGs

A

HCO3 deficit in the ECF
pH < 7.35 (L/acidic)
PaCO2: 35-45
HCO3- <24 (L)

24
Q

metabolic acidosis: causes

A

-renal failure
-fistulas
-DKA
-lactic acidosis
-prolonged diarrhea (lose bicarb)
-starvation (ketosis)
-shock & cardiac arrest

25
Q

metabolic acidosis: clinical manifestations

A

-lethargy, drowsiness, confusion, tremors, muscle cramps, paresthesia
-hypotension
-hyperkalemia
-deep breathing (kussmaul respirations in DKA)

26
Q

summary of respiratory comp

A

Rate: rapid
Organ: Lungs
activity: hyper/hypo vent
trigger: met acid-base abnorm

27
Q

summary of metabolic comp

A

Rate: slow
Organ: Kidneys
activity: retention/excretion of H+/HCO3
trigger: resp acid-base abnorm

28
Q

what do we do for pt w/ respiratory acidosis

A

-give narcan if drug related
-bag mask
-intubate
do not give bicarb bc doesn’t fix respiratory problem

29
Q

what would some w/ respiratory acidosis ABGs look like if they have COPD

A

they will be fully compensated
pH: normal
PCO2: high
HCO3: high

30
Q

what would we do for a patient with respiratory alkalosis

A

-calm
-anti anxiety meds
-breathing into paper bag
-rebreather

31
Q

what will someones ABGs look like in respiratory alkalosis who is fully compensated

A

pH: normal/basic
PCO2: low
HCO3: low

32
Q

what do for someone w/ metabolic acidosis

A

treat the cause
ex: if DKA, bring down BG

33
Q

what would someones ABGs look like if they have fully compensated metabolic acidosis

A

pH: normal - acidic
PacCO2: low
HCO3: low

34
Q

with compensation, the arrow will always move….

A

in the same direction as the disorder

35
Q

what would someones ABGs look like if they have fully compensated metabolic alkalosis

A

ph: normal
PaCO2: high
HCO3: high

36
Q

treatment for metabolic alkalosis

A

treat the cause so if vomiting give drugs to reduce gastric hydrochloric acid secretions

37
Q

what is the parameters for the pH to be leaning after compensation has occurred

A

neutral = 7.4
-leaning toward acidic: <7.4
-leaning toward base: >7.4

38
Q

uncompensated

A

pH abnormal, acid or base abnormal

39
Q

partially compensated

A

pH abnormal, acid and base component abnormal

40
Q

compensated

A

pH normal, acid or base imbalance is neutralized but not corrected -> arrows moving in same direction

ABSN (161 decks)

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