Acid/Base Flashcards
ABGs are frequently used to detect and monitor indices of what 3 things?
- Oxygenation
- Ventilation
- Acid-base balance
ABGs quantify levels of _____ & ______.
- carboxyhemoglobin
- methemoglobin
ABG
- Blood is drawn usually from what artery?
- Sometimes drawn from what other 2 arteries?
- Blood is collected with _____ and placed on ice and taken quicky to lab for prompt analysis
- Results are usually back within _____.
- Radial
- Brachial or femoral aa
- anticoagulant (heparin)
- 5 - 15 mins
Oxygenation
- The pO2 is just used in determining ____.
- NOT in the determination of _____.
- Is pO2 from ABG or pulse ox more reliable way to check oxygenation?
- How well pt is oxygenating
- NOT: acid base conditions
- pO2 from ABG is more reliable than pulse ox.
- Body maintains precise control of ____ to maintain homeostasis
- ____ are used to keep pH in narrow range.
- Hydrogen ions
- Buffer systems
- Acidemia is pH <____
- Alkalemia is pH >____
- <7.35
- >7.45
pH of blood
Acidemia & Alkalemia
Acid/Base Disorder
Acidosis & Alkalosis
Tx for acid/base disturbances?
Management of underlying disease
(can have up to 3 disorders)
- 2 types of compensation for acid/base disorders?
- Which one is rapid and which is slow?
- Respiratory compensation (rapid)
- Metabolic compensation (days - weeks)
Acid/Base
- A primary respiratory problem involves ___
- If greater than ___ is acidosis
- If less than ____ is alkalosis
- pCO2
- >45 = acidosis
- <35 = alkalosis
Acid/Base
- Primary metabolic problem involves ____.
- If greater than ___ is alkalosis
- If less than ____ is acidosis
- pH: >7.45
- Disturbance: decreased pCO2 (<35)
- Secondary response: decreased HCO3
Respiratory Alkalosis
- pH: >7.45
- Disturbance: increased HCO3 (>26)
- Secondary response: increased pCO2
Metabolic Alkalosis
- pH: <7.35
- Disturbance: increased pCO2 (>45)
- Secondary response: increased HCO3
Respiratory acidosis
- pH: <7.35
- Disturbance: decreased HCO3 (<22)
- Secondary response: decreased pCO2
Metabolic acidosis
If both pCO2 and HCO3 are HIGH, what could it be?
- Respiratory acidosis
- Metabolic alkalosis
If both pCO2 and HCO3 are LOW, what could it be?
- Respiratory alkalosis
- Metabolic acidosis
If pCO2 and HCO3 are moving in opposite directions, there is what?
Mixed disorder is present
What causes high anion gap metabolic acidosis?
- Methanol
- Uremia
- DKA
Propylene glycol - Iron/Isoniazid
- Lactate
- Ethanol/ethylene glycol
- Salicylates/starvation
(MUDPILES)
Causes of non-anion gap metabolic acidosis
- GI bicarbonate loss
- Renal bicarbonate losses
- Hyperchloremia due to saline resuscitation
Tx of Metabolic Acidosis
- Consider giving _____ to help w/ immediate period until you’ve treated the underlying cause
- Allow for ______.
- Pts will be _____ in order to compensate, so avoid giving certain meds
- Sodium bicarbonate
- Respiratory compensation
- Hyperventilating, so don’t give meds which depress their resp drive
If urine chloride <25 = ____ responsive metabolic alkalosis
- 3 causes
- HCO3 >___
- Tx?**
<25
- GI losses
- Diuretics (contraction alkalosis)
- Cystic fibrosis
- Tx w/ FLUIDS!!
If urine chloride >25 = _____ responsive metabolic alkalosis
- 7 causes?
- Tx?
Non-chloride responsive metabolic alkalosis
- Barter’s syndrome
- Cushing’s
- Hyperaldosteronism
- K depletion
- Citrate toxicity for massive blood transfusion protocol
- Chronic diuretics
- Renin secreting tumor
- Tx underlying cause, may need potassium