Acid-Base (ABGs) Flashcards
what is the most effective buffering system?
Renal Buffering
what is respiratory buffering?
it happens when there is an increase in CO2, there is more hydrogen ions. this lowers pH to which creates acidotic state. then RR increases to let out the CO2 out. which then the CO2 decreases, which hydrogen ions decreases leading to a higher pH. RR will slow to conserve CO2. (changes in RR will alter pH faster than metabolic changes)
what is renal buffering in alkalosis?
begins within hours but requires several days.
in alkalosis, kidneys release bicarb, which reabsorb hydrogen ions. urine will be more alkaline which decrease pH.
what is renal buffering in acidosis
kidney excrete hydrogen ions, reabsorb bicarb. urine becomes acidic, and pH increases.
whose at risk for ABGs abnormalities?
very young and very old.
normal pH
7.35-7.45
normal PaCO2
35-45
normal HCO3
22-26
what does it need to be partially compensated?
pH- abnormal
CO2- abnormal
HCO3- abnormal
fully compensated?
pH- normal
CO2- abnormal
HCO3- abnormal
primary prevention for acid-base imbalance?
healthy eating
safe weight loss
smoking cessation
poison control
safe food handling
exemplars for respiratory acidosis
asthma
bacterial pneumonia
COPD
exemplars for metabolic acidosis
DKA
severe hypovolemia
circulatory shock
oliguric renal disease
exemplars for respiratory alkalosis
hyperventilation
exemplars for metabolic alkalosis
prolonged vomiting
mild hypovoemia
hypokalemia
normal PaO2
80-100
what pH is considered lethal?
less than 6.8
more than 7.8
how do you perform and ABG sample?
aspesis
herparinized syringe
direct pressure for at least 5 minutes, or 20 min if theyre on anticoag.
how do you do allen’s test?
- pt clench their fist
occlude their radial/ulnar arties
have pt open hand
remove pressure from ulnar artery
color should return to hand
causes for respiratory acidosis
cns depression
excessive o2 to copd
PE
ards
sleep apnea
pneumothorax
myasthenia gravis
Guillain-barre
S/S or respiratory acidosis
dyspnea
respiratory distress
tachycardia
low LOC
low BP
HYPERKALEMIA
dysrhythmias
tx for respiratory acidosis
o2
hydration
semi fowler
deep breathing
bronchodialotrs
mucolytic
antibiotics if infection
thrombolytic if PE
mechanical ventilation
causes for respiratory alkalosis
hyperventilation, fever, pain,
S/S for respiratory alkalosis
tachycardia/tachypnea
lightheadedhness
confusion
hypokalemia
hypocalcemia
TETANY
cramping
tx respiratory alkalosis
anti-anxiety
slow, deep breathing
rebreather mask
oxygen= if hypoxic
causes for metabolic acidosis
renal failure, diarrhea, loss of fluid in gi tract, DKA, fasting
S/S for metabolic acidosis
low LOC, drowsy
KUSSMAUL respiration
HOTN
low CO
hyperkalemia
dysthymias
tx for metabolic acidosis
sodium bicard (PH<7.1)
monitor high potassium levels
monitor low calcium levels
causes for metabolic alkalosis
vomiting, gastric suction, excessive antacids
s/s metabolic alkalosis
hypocalcemia
hypokalemia
respiratory depression
tachycardia
tetany
seizures
tx for metabolic alkalosis
stop diuretics
IVF with NS
KCL to IVF
s/s for acidosis for saunders
lethargy
confusion
dizzy
headache
coma
dysthymias
muscle weakness
seizures
s/s for respiratory acidosis (saunders)
warm
flushed skin
respiratory rate increased
s/s for metabolic acidosis
cold
clammy skin
nausea, vomiting, diarrhea, abdominal pain
KUSSMAUL respiration
