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MK REVIEW > Acid Base Balance and Ventilators > Flashcards

Acid Base Balance and Ventilators Flashcards

1
Q

When interrupting blood gases what are the rule or “B’s”

A

If the pH and BICARB and BOTH in the same direction then its MetaBOLIC (Bicarb, Both, Bolic).

If directions are different then its RESPIRATORY!

Out of all 8 lab values always look at pH & BICARB if direction is the SAME then its METABOLIC if its DIFFERENT then its RESPIRATORY!

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2
Q

What are the lab values for pH and Bicarb

A

pH: 7.35-7.45

Bicarb (HCO3): 22-26 ( 2+2+2=6)

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3
Q

What is the acid base imbalance if the If the pH is 7.30 and the Bicarb is 21?

A

Metabolic Acidosis

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4
Q

What is the acid base imbalance if the If the pH 7.31 and the Bicarb is 27?

A

Respiratory Acidosis

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5
Q

What is the acid base imbalance if the If the pH 7.50 and Bicarb 25?

A

Respiratory Alkalosis

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6
Q

What is the pH principle?

A

As the pH goes, so goes my patient, Except or Potassium.

pH > then pt. body system >
pH < then pt. body system <
Except for potassium when pH< K+> & pH> K<

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7
Q

Signs and Symptoms of pH Alkalosis

A 
Irritability
Hypereflexia +3 or +4
Tachyepenia
Tachycardia 
Borborygmi (> bowel sounds)
Seizure (Suction b/c aspiration)
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8
Q

Signs and Symptoms of pH Acidosis

A 
Hypoflexia 0-1
Bradycardia
Lethargy - obtundent
Paralytic illeus
Coma 
Respiratory Arrest (ambu bag)
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9
Q

What type of breathing would you find in a pt. with Metabolic Acidosis?

A

Metabolic ACidosis = Kussmauls breathing

AKA: MACKUSSMAULS

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10
Q

Your pt. has respiratory acidosis select all that apply:

  1. +1 Reflex
  2. Diarrhea
  3. Adynamic Illeus
  4. Spasm >
  5. Urinary rentention
  6. Paroxysmal (spasm or seizure)
  7. Atria tach with 2nd degree morbid T2 heart block.
  8. Hypokamlemia
A
  1. +1 Reflex
  2. Adynamic Illeus
  3. Urinary retention
  4. Atria tach with 2nd degree morbid T2 heart block.
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11
Q

Causes of Acid Base Imbalance?

A

What causes acid base imbalance its often times what causes something. i.e. diarrhea

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12
Q

Causation: when ever you are faced with an acid base scenario what 2 questions do you ask yourself?

A
  1. Is it LUNG? if YES then RESPIRATORY. NO = Metabolic

2. OVER-ventilating (Resp. Alkalosis) or UNDER-ventilating (Resp. acidosis)

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13
Q

Question: Female pt. is over zealously using breathing techniques.
Ask: Is it lung?
is she OVER-ventilating or UNDER-ventilating.
What acid base imbalance does she have?

A

Respiratory Alkalosis

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14
Q

Question: Child drowning.
Ask: Is it lung?
is she OVER-ventilating or UNDER-ventilating.
What acid base imbalance does she have?

A

Respiratory acidosis

  • Remember with Acid base imbalance focus on the
    SAO2 NOT the respiratory rate.
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15
Q

PCP PUMP: What acid base imbalance tells you the pt. needs to come off the pump?

A

Metabolic Acidosis - under-ventilating

Note: PCP pump suppresser’s ventilation.

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16
Q

If the scenario is not Lung then its?

A

Metabolic

17
Q

If pt. has PROLONGED GASTRIC VOMITING or SUCTIONING pick?

A

Metabolic Alkalosis because the pt. is losing acid.

18
Q

When you dont know what to pick….pick?

A

Metabolic Acidosis

19
Q

Summary:

A

If the pH and the Bicarb are in the same direction then its METABOLIC.

As the pH goes, so goes my pt. - Except for Potassium!

Who’s your favorite Scottsman? MAKUASMAULS

OVER-ventilate (Alkalosis) /UNDER-ventilate( Acidotic) -
Translate.

When you want to get a question right always pay more attention to the modifying question then the original noun.

20
Q

Ventilation: Describe alarm systems

A

High pressure alarms are triggered by increased resistance to air flow in the other words the machine is having to push to hard to get air into the lungs there is resistance therefore machine will set off a high pressure alarm. Set up includes nurse setting the pressure.

21
Q

Alarms are due to 3 obstructions what are they?

A
  1. Kinks - unkink it.
  2. Water condensing in dependent loops- so empty it!
  3. Mucus Secretion in airway
    FIRST turn, cough, deep breath,
    SECOND suction as needed.

Note its better to turn pt. than suction.

22
Q

High pressure alarm goes off what do you do FIRST?

  1. Turn, cough, deep breath
  2. Remove Kinks
  3. Empty water out of tubing
  4. Suction
A
  1. Remove Kinks
  2. Empty water out of tubing
  3. Turn, cough, deep breath
  4. Suction
23
Q

Low pressure alarms mean what?

A

Decreased resistance

24
Q

What causes low pressure alarms?

A

DISCONNECTION

  1. Disconnect to main tubing - so, reconnect
  2. O2 sensor tubing, which senses FaO2 at trach, which is the black coated wire that piggy backs along tubing plug back in
25
Q

What are high pressure alarms do to? and what are low pressure alarms do to?

A

High pressure = obstruction

Low pressure = Disconnections

26
Q

Acid Base Disorders: Respiratory Alkalosis means ventilators are what?

A

Too High! Over ventilating means ventilator may be set to high and visa versa with metabolic acidosis.

MK REVIEW (16 decks)

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