ABGs Tutorial

Question 1

pH ranges from ___ to ___

Answer 1

7.35 to 7.45

Question 2

pH for acidosis

Answer 2

<7.35

Question 3

pH for alkalosis

Answer 3

> 7.45

Question 4

normal range for PCO2?

Answer 4

35-45 mmHg

Question 5

is PCO2 acid or base?

Answer 5

acid

Question 6

normal range for PO2?

Answer 6

80-100 mmHg

Question 7

normal range for HCO3?

Answer 7

22-26 mEq/L

Question 8

is HCO3 acid or base?

Answer 8

base

Question 9

what is ROME?

Answer 9

Respiratory
Opposite (to pH)
Metabolic
Equal (to pH)

Question 10

respiratory acidosis

Answer 10

increased PCO2 (>45 mmHg)
pH <7.35

Question 11

respiratory alkalosis

Answer 11

decreased PCO2 (<35mmHg)
pH>7.45

Question 12

metabolic acidosis

Answer 12

decreased HCO3 (<22 mEq/L)
decreased pH (<7.35)

Question 13

metabolic alkalosis

Answer 13

increased HCO3 (>26 mEq/L)
increased pH (>7.45)

Question 14

Clinical manifestations of respiratory alkalosis (9)

Answer 14

lethargy, lightheadedness, confusion, tachycardia, dysrhythmias related to hypokalemia, n/v, epigastric pain, numbness/tingling of the extremities, hyperventilation (tachypnea)

Question 15

atelectasis

Answer 15

condition characterized by the collapse of alveoli, preventing the respiratory exchange of oxygen and carbon dioxide in a part of the lungs

Question 16

respiratory acidosis is associated with hypo/hyperventilation?
respiratory alkalosis is associated with hypo/hyperventilation?

Answer 16

hypoventilation

hyperventilation

Question 17

Clinical manifestations of respiratory acidosis (9)

what happens for resp rate?

Answer 17

the respiratory rate and depth increase in an attempt to compensate. The client also experiences headache; restlessness; mental status changes, such as drowsiness and confusion; visual disturbances; diaphoresis; cyanosis as the hypoxia becomes more acute; hyperkalemia; rapid, irregular pulse; and dysrhythmias.

Question 18

what does applying pressure over the puncture site do?

Answer 18

reduces the risk of hematoma formation and damage to the artery

Question 19

DM can lead to…? why?

can potentially lead to what disease?

Answer 19

Metabolic acidosis

by product of fat metabolism are acidotic, potentially leading to the condition known as diabetic ketoacidosis

Question 20

Clinical manifestations of metabolic acidosis (10)

Answer 20

hyperpnea with Kussmaul’s respirations; headache; n/v, and diarrhea; fruity-smelling breath resulting from improper fat metabolism; central nervous system depression, including mental dullness, drowsiness, stupor, and coma; twitching; and convulsions. Hyperkalemia

Question 21

what are extrapulmonary causes of respiratory failure? (6)

Answer 21

stroke, sleep apnea, myasthenia gravis, and opioid analgesics, sedatives, and anesthetics

Question 22

what are intrapulmonary causes of respiratory failure? (2)

Answer 22

obstructive lung disease and pneumonia

Question 23

why is the allen test imporant?

Answer 23

ensures collateral circulation to the hand if thrombosis of the radial artery occurs after the puncture

Question 24

what happens if there is failure to determine the presence of adequate collateral circulation?

Answer 24

could result in severe ischemic injury to the hand if damage to the radial artery occurs with arterial puncture.

Question 25

what is Cheyne-Stokes respirations?

Answer 25

rhythmic crescendo and decrescendo of rate and depth, including brief periods of apnea

Question 26

The nurse who is trying to enhance the client's respiratory status for respiratory acidosis should implement what 3 actions?

Answer 26

keep HOB elevated monitor flow rate of supplemental oxygen assist client to turn, cough, & breathe deeply

Question 27

which serum level tends to rise with metabolic acidosis? what happens?

Answer 27

potassium When acidosis is corrected with treatment, the potassium will shift back into the cellular compartment from the bloodstream

Question 28

neutropenia

Answer 28

low WBC count

Question 29

Disorientation and dyspnea

Answer 29

respiratory acidosis

Question 30

Drowsiness, headache, and tachypnea

Answer 30

metabolic acidosis

Question 31

Tachypnea, dizziness, and paresthesias

Answer 31

respiratory alkalosis

Question 32

Decreased respiratory rate and depth

Answer 32

metabolic alkalosis

Question 33

nasogastric suctioning may cause...

Answer 33

metabolic alkalosis (decreasing acid components in stomach)

Question 34

Excess alcohol ingestion and salicylate toxicity may cause?

Answer 34

metabolic acidosis

Question 35

fentanyl is what kind of medication? what can it cause?

Answer 35

opioid | respiratory acidosis

Question 36

tingling and numbness of the fingers, restlessness, and tetany caused by irritability of the central nervous system (CNS) results

Answer 36

alkalosis

Question 37

Guillain-Barré syndrome

Answer 37

neuromuscular disorder in which the client may experience weakening or paralysis of the muscles used for respiration.

Question 38

buffer system

Answer 38

fastest acting system | primary regulator of acid base balance

Question 39

what does buffer do?

Answer 39

change strong acids --> weaker cids | bind acids to neutralize their effects

Question 40

how are rate and depth of breathing regulated?

Answer 40

chemoreceptors in medulla

Question 41

three mechanisms of acid elimination

Answer 41

1. secretion of free H+ into renal tubule 2. combo of H+ with ammonia (NH3) to form ammonium (NH4+) 3. excretion of weak acid

Question 42

to compensate for acidosis, what can the kidneys do?

Answer 42

generate additional bicarbonate & eliminate excess H+, lowering the pH of the urine

Question 43

causes of metabolic acidosis

Answer 43

DKA, renal failure, lactic acidosis, diarrhea, starvation, alcohol drinking

Question 44

causes of metabolic alkalosis

Answer 44

Vomiting, GI suction, bicarb intake, diuretics that cause hypokalemia

Question 45

causes of respiratory acidosis

Answer 45

Depressed ventilation (Hypoventilation), COPD, chest wall deformities

Question 46

causes of respiratory alkalosis

Answer 46

Hyperventilation (e.g. due to anxiety or high altitude)

Question 47

clinical manifestation of both respiratory and metabolic acidosis

Answer 47

CNS depression (headache, lethargy, weakness, confusion)

Question 48

complete compensation

Answer 48

both CO2 and HCO3 are abnormal in same direction | pH is normal

Question 49

partial compensation

Answer 49

both CO2 and HCO3 are abnormal in same direction | pH is outside normal range

Question 50

primary disorder is identified based on what pH?

Answer 50

7.40 pH<7.40 = primary acidosis pH>7.40 = primary alkalosis

Question 51

combined acidosis

Answer 51

resp & metabolic acidosis | CO2 is high and HCO3 is low

Question 52

combined alkalosis

Answer 52

resp & metabolic alkalosis | CO2 is low and HCO3 is high