Acid Base and Ventilators

Question 1

What is normal pH?

Answer 1

7.35-7.45

Question 2

What is normal CO2?

Answer 2

35-45

Question 3

What is normal HCO3 (bicarb)?

Answer 3

22-26

Question 4

If pH and Bicarb Both move in the same direction then it is…. if they move opposite then it is…

Answer 4

MetaBolic

Respiratory

Question 5

As the pH goes up… except for…

What does that look like?

Acidosis/alkalosis

Answer 5

As the pH goes up so does my patient except for potassium

Tachycardia, seizures, HTN, tachypnea, irritability, spastic, diarrhea, borborygmi, hyperreflexia

Alkalosis

Question 6

As the pH goes down… except for…

What does that look like?

Acidosis/alkalosis

Answer 6

If the pH goes down, so does my patient except for potassium

Bradycardia, constipation, absent bowel sounds, flaccid, obtunded, lethargy, coma, hyporeflexia, bradypnea, hypotension

Acidosis

Question 7

What does MAC kussmaul mean?

Answer 7

Metabolic ACiodisis is the only one with kussmaul respirations d/t compensation

Question 8

How do you determine the causation of acid/base imbalance?

Answer 8

Ask yourself if it is lung, if it is then you know it is caused by respiratory. If it is not then you know it is metabolic

Question 9

When it is lung (caused by respiratory) how do you know if it is acidosis or alkalosis?

Answer 9

If UNDERventilating, then pick acidosis (pH is under 7.35)

If OVERventilating, then it is alkalosis (pH is over 7.45)

Question 10

When it is not lung (caused by metabolic) how do you know if it is acidosis or alkalosis?

Answer 10

Prolonged gastric vomitting or suction –> alkalosis

EVERYTHING ELSE (diarrhea, renal failure, burns) –> acidosis

Question 11

What does high pressure alarms mean?

Common causes?

Answer 11

Increased resistance to airflow

Kinks, condensed water in tube, mucus plug

Question 12

If a high pressure alarm is occurring what interventions should you preform?

Answer 12

1. Unkink
2. Empty water out of the tube
3. Turn patient, cough, deep breath
4. Suction

Question 13

What does a low pressure alarm mean? Common causes?

Answer 13

Decreased resistance to airflow

Main tubing disconnection, O2 sensor tube disconnection

Question 14

What acid base imbalance occurs if the setting it too high on a vent?

Answer 14

Patient is overventilated

Respiratory alkalosis (panting –> blow off too much CO2)

Question 15

What acid base imbalance occurs if the setting it too low on a vent?

Answer 15

Underventilated

Respiratory acidosis (retaining CO2)