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Medicine > Acid-Base Disorders > Flashcards

Acid-Base Disorders Flashcards

1
Q

PCO2

A

partial plasma for CO2

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2
Q

what values are found in an ABG?

A

pH, HCO3, PCO2

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3
Q

when do you do the Allen test?

A

prior to drawing blood

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4
Q

why do we order an ABG?

A

assess respiratory (ventilation) and metabolic (renal) and electrolyte homeostasis

  • manage ventilator
  • pre-op assessment
  • acute/critical illness assessment
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5
Q

why do we use radial instead of femoral artery?

A

it is a cleaner site

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6
Q

what does the allen test accomplish?

A

identifies if the ulnar artery will compensate for the radial artery if you block it while taking the sample
-ensures patency

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7
Q

what kind of test tube will you use to get a blood gas?

A

green top (heparin)

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8
Q

how quickly should your blood gas sample get to the lab?

A

ASAP or place on ice

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9
Q

one or two sticks?

A

you may use lidocaine to numb the area prior to drawing blood from the RA

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10
Q

positive Allen test means

A

ulnar artery is not patent and you cannot use that hand (7-10 seconds return)

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11
Q

contraindications for RA

A 
no palpable pulse
cellulitis or open infection
AV fistula
severe coagulopathy
positive Allen test
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12
Q

what are the potential complications of drawing a blood gas?

A

arterial occlusion

penetration of other important structures nearby

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13
Q

what is the normal pH of arterial blood?

A

7.4

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14
Q

what is the normal pH of venous blood and interstitial fluid

A

7.35 (has extra CO2 released from nearby tissues that makes it more acidic)

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15
Q

what is the normal pH of intracellular fluid

A

estimated to be between 6.0-7.4

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16
Q

what is considered acidosis?

A

<7.35

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17
Q

what is considered alkalosis?

A

> 7.45

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18
Q

what are the lower and upper limits of pH that support life?

A

6.8<8.0 (more than a few hours at the high and low end will end life)

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19
Q

where is Hydrogen found most?

A

intracellular (which makes cells more acidic)

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20
Q

what is the alkaline substance in the body?

A

HCO3

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21
Q

what is the acidic substance in the body?

A

H+ and CO2 (H2CO3)

22
Q

how does the body hold onto CO2?

A

breathing slower (found in alkaline patients)

23
Q

where is bicarb manufactured?

A

kidney (slower than the lungs when it comes to compensation)

24
Q

which organ responds first when pH becomes out of balance?

A

lungs

25
Q

which organ controls retention and secretion of H+

A

kidney

26
Q

what are the normal values for bicarb?

A

22-26 mEq/L

27
Q

what is the alkalotic value of bicarb?

A

> 26

-metabolic alkalosis

28
Q

what is the acidic value of bicarb?

A

<22

-metabolic acidosis

29
Q

what are the normal values of PCO2?

A

35-45 mm/Hg

30
Q

what is the alkalotic value of PCO2

A

<35

-respiratory alkalosis

31
Q

what is the acidodic value of PCO2

A

> 45

-respiratory acidosis

32
Q

metabolic acidosis

A

acidosis caused by a primary decrease in bicarb

-diarrhea (loss of HCO3 in feces)

33
Q

metabolic alkalosis

A

caused by a primary increase in bicarb concentration

-drug overconsumption of HCO3 (overcorrecting in renal disease)

34
Q

respiratory acidosis

A

caused by an increase in PCO2 from a respiratory disturbance

-hypoventilation (drug use)

35
Q

respiratory alkalosis

A

caused by a decrease in PCOz from a respiratory disturbance

-hyperventilation (anxiety)

36
Q

what is the time frame of the renal compensatory response?

A

several hours to 3-5 days

37
Q

what is the time frame of the respiratory compensatory response?

A

minutes to max in several hours

38
Q

SOB can also be called

A

hyperventilation (compensatory response of acidosis)

39
Q

how much will ventilation increase in acidosis?

A

4-5 times normal

40
Q

how much will ventilation slow down in alkalosis?

A

will slow but not as significantly

41
Q

COPD who are former smokers are in a chronic state of

A

respiratory acidosis

42
Q

what is metabolic compensation in acidosis?

A

reabsorb all filtered HCO3
produce new HCO3 which is added back into the extracellular fluid
secrete H+
-net effect is lowered extracellular H+

43
Q

what is metabolic compensation in alkalosis

A

increase secretion of HCO3

most of the compensation is respiratory

44
Q

what is a chem 7

A

BMP

45
Q

what CO2 does the BMP come with?

A

not the same as a ABG

46
Q

what is the formula to calculate anion gap?

A

Na - Cl+HCO3 (from blood gas)

47
Q

what does elevated anion gap indicate?

A

metabolic acidosis

48
Q

what is the Delta gap?

A

excess anion gap

AG-12 +HCO3

49
Q

what does <23 delta gap indicate?

A

metabolic acidosis

50
Q

what does >30 delta gap indicate?

A

metabolic alkalosis

Medicine (146 decks)

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