Acid Base Balance & Ventilators Flashcards

1
Q

What two values should be looked at FIRST when interpreting ABGs?

A

PH and HCO3

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2
Q

If pH and HCO3 are in the same direction then it’s _________. If pH and HCO3 are in different directions then it is _________.

A

Metabolic; respiratory

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3
Q

Normal pH

A

7.35-7.45

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4
Q

Normal HCO3

A

22-26

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5
Q

Normal CO2

A

35-45

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6
Q

What happens to body systems as pH goes up/down?

A

Up: body systems become irritable/hyperexcitable
Down: body systems shut down
(REMEMBER: the direction pH goes, so does the patient, EXCEPT for K+)

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7
Q

PH and K+ have an _________ relationship

A

Inverse (when pH goes up, K+ goes down; when pH goes down, K+ goes up)
(IN OTHER WORDS: alkalosis = hypokalemia; acidosis = hyperkalemia)

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8
Q

S/S of alkalosis

A

Neuro: irritability, hyperreflexia (3 & 4+), seizure
Cardiac: tachycardia
Respiratory: tachypnea
GI: borborygmi (increased bowel sounds)

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9
Q

Nursing consideration for a patient experiencing alkalosis

A

Keep suction at bedside d/t risk of seizure and aspiration

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10
Q

S/S of acidosis

A

Neuro: lethargy, obtunded, hyporeflexia (0-1+), coma
Cardiac: bradycardia
Respiratory: respiratory arrest
GI: paralytic ileus

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11
Q

Nursing consideration for patient experiencing acidosis

A

Keep bag-mask/ambu-bag at bedside d/t risk of respiratory arrest

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12
Q

Which acid-base imbalance can result in kussmal respirations?

A

Metabolic acidosis

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13
Q

Reflexes lab values

A

Hyporeflexia: 0-1
Normal: 2
Hyperreflexia: 3-4

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14
Q

Which acid-base imbalance is caused by over-ventilating?

A

Respiratory alkalosis (REMEMBER: pH is OVER the expected range with ALKALOSIS, and the patient is OVER-ventilating)

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15
Q

Which acid-base imbalance is caused by under-ventilating?

A

Respiratory acidosis (REMEMBER: pH is UNDER the expected range with ACIDOSIS, and the patient is UNDER-ventilating)

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16
Q

Which scenarios result in metabolic alkalosis?

A

Prolonged gastric vomiting or suctioning

17
Q

Scenarios that do not involve the lungs, vomiting, or suctioning are likely to be categorized as which acid-base imbalance?

A

Metabolic acidosis

18
Q

High pressure alarm is set off by _________ resistance to airflow

A

Increased

19
Q

Causes of high pressure alarm

A

OBSTRUCTIONS: kinks in tubing, water condensing within tube/dependent loops, mucus secretions

20
Q

Low pressure alarm is set off by _________ resistance to airflow

A

Decreased

21
Q

Causes of low pressure alarms

A

DISCONNECTIONS: main tubing, oxygen sensor tubing

22
Q

Ventilator settings may be TOO HIGH if the patient is _____-ventilating/in respiratory _________

A

Over; Alkalosis

23
Q

Ventilator settings may be TOO LOW if the patient is _____-ventilating/in respiratory _________

A

Under; Acidosis