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PRNU 131 > Acid Base Balance and ABG Interpretation > Flashcards

Acid Base Balance and ABG Interpretation Flashcards

1
Q

what is the normal pH of the body?

A

7.35-7.45

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2
Q

what are the chemical buffers in our blood?

A

carbonic acid = PaCO2
bicarbonate = HCO3

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3
Q

what do our lungs do when there is too much CO2?

A

hyperventilation to exhale excess CO2

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4
Q

what do our lungs do when there is not enough CO2?

A

hypoventilation to avoid exhaling CO2

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5
Q

what controls the carbonic acid/respiratory buffer system?

A

medulla controls respiratory drive to get rid of or conserve CO2

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6
Q

what controls the metabolic buffer system?

A

kidneys excretes or reabsorbs hydrogen ions to produce appropriate amount of HCO3

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7
Q

what do the kidneys do when the blood is too acidic?

A

reabsorb H+ and form bicarbonate to increase pH (make it less acidic)

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8
Q

what do the kidneys do when the blood is too alkaline?

A

excrete bicarbonate to decrease pH (make it more acidic)

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9
Q

what value indicates acidosis?

A

pH <7.35

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10
Q

what value indicates alkalosis?

A

pH >7.45

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11
Q

what can cause respiratory alkalosis?

A

hyperventilation

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12
Q

signs and symptoms of respiratory alkalosis

A

seizures
deep rapid breathing, hyperventilation
tachycardia
low or normal BP
hypokalemia
numbness and tingling of extremities
lethargy, confusion, light headedness
N/V

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13
Q

treating respiratory alkalosis

A

treat underlying cause of hyperventilation
EKG
electrolyte imbalances (hypokalemia)
anxiolytics and sedatives
rebreathe CO2 - paper bag

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14
Q

what can cause metabolic alkalosis?

A

loss of gastric juices
potassium wasting diuretics cause loss of H+
overuse of antacids

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15
Q

signs and symptoms of metabolic alkalosis

A

restlessness and lethargy
tachycardia
compensatory hypoventilation
confusioon
N/V/D
tremors and cramps
tingling fingers and toes
hypokalemia

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16
Q

treating metabolic alkalosis

A

EKG
IV fluids
treat electrolyte imbalances
potassium supplementation

17
Q

what can cause respiratory acidosis?

A

things that decrease ventilation:

drug overdose
airway obstruction
chest trauma
neuromuscular disease
pulmonary edema

18
Q

signs and symptoms of respiratory acidosis

A

hypoventilation and hypoxia
rapid shallow respirations
decreased BP
headache
dysrhythmias and weakness r/t hyperkalemia
drowsy, dizzy, disoriented

19
Q

treating respiratory acidosis

A

pulmonary toileting
vital signs
EKG
semi-fowlers
bronchodilators
treat electrolyte imbalances - hyperkalemia
supplemental O2 - caution with COPD
mechanical ventilation in ICU if needed

20
Q

what can cause metabolic acidosis?

A

DKA
sepsis
shock
renal failure
severe diarrhea

21
Q

signs and symptoms of metabolic acidosis

A

headache
low BP
hylerkalemia
muscle twitching
warm, flushed skin
N/V
changes in LOC
kussmaul respirations

22
Q

treating metabolic acidosis

A

EKG
IV fluids if caused by diarrhea
treat electrolyte imbalances - hyperkalemia
dialysis
IV bicarb, insulin if caused by DKA

23
Q

what electrolyte imbalance is associated with acidosis?

A

hyperkalemia

24
Q

what electrolyte imbalance is associated with alkalosis?

A

hypokalemia

25
Q

what treatment methods are used for all acid base imbalances?

A

Vital signs
EKG
treat electrolyte imbalances
monitor ABGs

26
Q

what is normal PaCO2?

A

35-45

can use pH (7.35-7.45) to remember this value

27
Q

what is normal HCO3?

A

22-26

28
Q

what is normal PaO2 (partial pressure of oxygen dissolved in blood)

A

80-100

29
Q

what is normal SaO2 (oxygen bound to hemoglobin)

A

> 94%

30
Q

how are PaO2 and SaO2 related?

A

partial pressure of oxygen drives binding to hemoglobin

need good PaO2 to achieve good SaO2

31
Q

what is the ROME mnemonic?

A

Respiratory = Opposite pH and CO2

increased pH and decreased CO2 = respiratory alkalosis
decreased pH and increased CO2 = respiratory acidosis

Metabolic = Equal pH and HCO3

increased pH and increased HCO3 = metabolic alkalosis
decreased pH and decreased HCO3 = metabolic acidosis

32
Q

how to differentiate compensated vs uncompensated acid base imbalances

A

compensated - CO2 and HCO3 are both outside of reference range

uncompensated - one value is outside of reference range and one is WNL

partial compensation if both are outside of reference range but pH is still not WNL

full compensation if both are outside of reference range and pH is WNL

PRNU 131 (18 decks)

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