ABGs Tutorial Flashcards
pH ranges from ___ to ___
7.35 to 7.45
pH for acidosis
<7.35
pH for alkalosis
> 7.45
normal range for PCO2?
35-45 mmHg
is PCO2 acid or base?
acid
normal range for PO2?
80-100 mmHg
normal range for HCO3?
22-26 mEq/L
is HCO3 acid or base?
base
what is ROME?
Respiratory
Opposite (to pH)
Metabolic
Equal (to pH)
respiratory acidosis
increased PCO2 (>45 mmHg) pH <7.35
respiratory alkalosis
decreased PCO2 (<35mmHg) pH>7.45
metabolic acidosis
decreased HCO3 (<22 mEq/L) decreased pH (<7.35)
metabolic alkalosis
increased HCO3 (>26 mEq/L) increased pH (>7.45)
Clinical manifestations of respiratory alkalosis (9)
lethargy, lightheadedness, confusion, tachycardia, dysrhythmias related to hypokalemia, n/v, epigastric pain, numbness/tingling of the extremities, hyperventilation (tachypnea)
atelectasis
condition characterized by the collapse of alveoli, preventing the respiratory exchange of oxygen and carbon dioxide in a part of the lungs
respiratory acidosis is associated with hypo/hyperventilation?
respiratory alkalosis is associated with hypo/hyperventilation?
hypoventilation
hyperventilation
Clinical manifestations of respiratory acidosis (9)
what happens for resp rate?
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.
what does applying pressure over the puncture site do?
reduces the risk of hematoma formation and damage to the artery
DM can lead to…? why?
can potentially lead to what disease?
Metabolic acidosis
by product of fat metabolism are acidotic, potentially leading to the condition known as diabetic ketoacidosis
Clinical manifestations of metabolic acidosis (10)
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
what are extrapulmonary causes of respiratory failure? (6)
stroke, sleep apnea, myasthenia gravis, and opioid analgesics, sedatives, and anesthetics
what are intrapulmonary causes of respiratory failure? (2)
obstructive lung disease and pneumonia
why is the allen test imporant?
ensures collateral circulation to the hand if thrombosis of the radial artery occurs after the puncture
what happens if there is failure to determine the presence of adequate collateral circulation?
could result in severe ischemic injury to the hand if damage to the radial artery occurs with arterial puncture.
what is Cheyne-Stokes respirations?
rhythmic crescendo and decrescendo of rate and depth, including brief periods of apnea
The nurse who is trying to enhance the client’s respiratory status for respiratory acidosis should implement what 3 actions?
keep HOB elevated
monitor flow rate of supplemental oxygen
assist client to turn, cough, & breathe deeply
which serum level tends to rise with metabolic acidosis? what happens?
potassium
When acidosis is corrected with treatment, the potassium will shift back into the cellular compartment from the bloodstream
neutropenia
low WBC count
Disorientation and dyspnea
respiratory acidosis
Drowsiness, headache, and tachypnea
metabolic acidosis
Tachypnea, dizziness, and paresthesias
respiratory alkalosis
Decreased respiratory rate and depth
metabolic alkalosis
nasogastric suctioning may cause…
metabolic alkalosis (decreasing acid components in stomach)
Excess alcohol ingestion and salicylate toxicity may cause?
metabolic acidosis
fentanyl is what kind of medication? what can it cause?
opioid
respiratory acidosis
tingling and numbness of the fingers, restlessness, and tetany caused by irritability of the central nervous system (CNS) results
alkalosis
Guillain-Barré syndrome
neuromuscular disorder in which the client may experience weakening or paralysis of the muscles used for respiration.
buffer system
fastest acting system
primary regulator of acid base balance
what does buffer do?
change strong acids –> weaker cids
bind acids to neutralize their effects
how are rate and depth of breathing regulated?
chemoreceptors in medulla
three mechanisms of acid elimination
- secretion of free H+ into renal tubule
- combo of H+ with ammonia (NH3) to form ammonium (NH4+)
- excretion of weak acid
to compensate for acidosis, what can the kidneys do?
generate additional bicarbonate & eliminate excess H+, lowering the pH of the urine
causes of metabolic acidosis
DKA, renal failure, lactic acidosis, diarrhea, starvation, alcohol drinking
causes of metabolic alkalosis
Vomiting, GI suction, bicarb intake, diuretics that cause hypokalemia
causes of respiratory acidosis
Depressed ventilation (Hypoventilation), COPD, chest wall deformities
causes of respiratory alkalosis
Hyperventilation (e.g. due to anxiety or high altitude)
clinical manifestation of both respiratory and metabolic acidosis
CNS depression (headache, lethargy, weakness, confusion)
complete compensation
both CO2 and HCO3 are abnormal in same direction
pH is normal
partial compensation
both CO2 and HCO3 are abnormal in same direction
pH is outside normal range
primary disorder is identified based on what pH?
7.40
pH<7.40 = primary acidosis
pH>7.40 = primary alkalosis
combined acidosis
resp & metabolic acidosis
CO2 is high and HCO3 is low
combined alkalosis
resp & metabolic alkalosis
CO2 is low and HCO3 is high
