Arterial Blood Gas

Question 0

Normal pH range

Answer 0

7.35-7.45

Question 1

Arterial blood gas is an essential part of diagnosing and managing

Answer 1

Oxygenation status
Ventilation failure
Acid base balance

Question 2

Normal PaO2 range

Answer 2

80-100 mmHg

Question 3

Normal PaCO2 range

Answer 3

35-45 mmHg

Question 4

Normal HCO3 range

Answer 4

22-26 mmol/L

Question 5

Bicarbonate is a _________ value.

Answer 5

Calculated

Question 6

The base excess indicates the amount of excess or insufficient level of

Answer 6

Bicarbonate

Question 7

Normal range of BE

A negative BE indicates a base

Answer 7

-2 to 2 mEq/L

Deficit in the blood

Question 8

Normal SaO2

Answer 8

> 95%

Question 9

A normal [H+] of ______ corresponds to a pH of 7.40

Answer 9

40 nEq/L

Question 10

Changes in pH are inversely related to changes in [H+]. A decrease in pH is associated with

Answer 10

An increase in [H+]

Question 11

How much CO2 does the body produce daily?

Answer 11

15,000 mmol

Question 12

How much nonvolatile acids does the body produce daily?

Answer 12

50-100 mEq nonvolatile acids

Question 13

What organs attempt to maintain balance of acids in the body?

Answer 13

Lungs and kidneys

Question 14

These two buffers work in pairs

Answer 14

carbonic acid and base bicarbonate

H2CO3 and NaHCO3

Question 15

The respiratory buffer response maintains that blood pH will change according to the level of ____ which triggers the lungs to

Answer 15

H2CO3

Increase or decrease the rate and depth of ventilation

Question 16

Activation of the lungs to compensate for an imbalance starts to occur within

Answer 16

1-3 min

Question 17

The renal buffer response is that kidneys excrete or retain bicarbonate. If blood pH decreases, the kidneys will compensate by

Answer 17

Entraining HCO3

Question 18

How long can it take the renal system to correct an imbalance?

Answer 18

Hours to days

Question 19

If decreased pH
Increased CO2
Decreased ventilation

Answer 19

Respiratory acidosis

Question 20

What can cause respiratory acidosis

Answer 20

CNS depression
Pleural disease
COPD/ARDS
Musculoskeletal disorders
Compensation for metabolic alkalosis
All of these can decrease ventilation

Question 21

What is the difference between acute and chronic respiratory acidosis?

Answer 21

Acute - little kidney involvement

Chronic - renal compensation via synthesis and retention of HCO3

Question 22

With acute resp acidosis, pH decrease by ___ for 10 mmHg increase in CO2

Answer 22

0.08

Question 23

Retention of CO2 results in decreased

Answer 23

Chloride

Can lead to hypochloremia because the body wants to balance charges

Question 24

With chronic resp acidosis, pH decreases by __ for 10 mmHg increase in CO2

Answer 24

0.03

Question 25

If increased pH Decreased CO2 Increased ventilation

Answer 25

Respiratory alkalosis

Question 26

What can cause respiratory alkalosis?

Answer 26

``` Inter cerebral hemorrhage Salicylate and progesterone drug usage Anxiety, which decreases lung compliance Cirrhosis of the liver Sepsis ```

Question 27

What is the difference between acute and chronic respiratory alkalosis?

Answer 27

Acute - HCO3 decreases by 2 mEq/L for every 10 mmHg in PCO2 | Chronic - HCO3 decreases by 4

Question 28

Respiratory alkalosis causes decreased bicarb _____ and decreased ______ excretion to normalize pH

Answer 28

Reabsorption, ammonium

Question 29

If decreased pH | Decreased HCO3

Answer 29

Metabolic acidosis

Question 30

What is Winter's formula and what does it tell you?

Answer 30

PCO2 = 1.5(HCO3) + 8 +/- 2 The degree of compensation for metabolic acidosis

Question 31

How long does it take for complete activation of respiratory compensation?

Answer 31

12-24 hours

Question 32

For met acidosis, there is a decrease of ____ for every decrease of 1 mEq/L HCO3

Answer 32

1.2 mmHg

Question 33

Causes of metabolic gap acidosis

Answer 33

``` Methanol Uremia DKA Paraldehyde INH Lactic acidosis Ethylene glycol Salicylate ```

Question 34

Causes of nongap metabolic acidosis

Answer 34

``` Hyperalimentation Acetazolamide RTA (calculate urine anion gap) Diarrhea Pancreatic fistula ```

Question 35

If increased pH | Increased HCO3

Answer 35

Metabolic alkalosis

Question 36

In metabolic alkalosis, PCO2 increases by ___ for every increase of 1 mEq/L in HCO3

Answer 36

0.7

Question 37

Metabolic alkalosis is caused by

Answer 37

``` Vomiting Diuretics Chronic diarrhea Hypokalemia Renal failure ```

Question 38

Mixed acid base disorders describes ___ acid base disorders at one time

Answer 38

Two or more

Question 39

What is the delta gap? What value equals metabolic alkalosis?

Answer 39

Delta HCO3 = HCO3 + change in anion gap | > 24

Question 40

What kind of respiratory problem is it if pH and PaCO2 move in opposite directions?

Answer 40

Primary

Question 41

What kind of problem is it if pH and HCO3 are moving in the same direction?

Answer 41

Primary

Question 42

What level of Pao2 indicates hypoxemia?

Answer 42

< 80 mmHg

Question 43

Change in PaO2 is associated with a change in pH, the disorder is ______. If the compensatory process brings the pH to within the clinically acceptable range (7.30 - 7.50), the disorder is

Answer 43

Acute, chronic

Question 44

The estimate of how much strong base or acid needed to correct the metabolic component of an acid base disorder is

Answer 44

Base excess

Question 45

The formula for the amount needed to correct an acid base disorder is

Answer 45

0.3 x body weight x BE

Question 46

Formula for anion gap

Answer 46

AG = (Na + K) - (Cl + HCO3)

Question 47

T or F. The system does not have the ability to overcompensate.

Answer 47

False

Question 48

If pH remains outside of the normal range after compensation, then it is

Answer 48

Partially compensated

Question 49

In a compensated state, when the pH decreases, PaCO2 should also decrease because

Answer 49

The lungs are acting as a buffer response

Question 50

Always strongly suggest a metabolic acidosis

Answer 50

High anion gap

Question 51

Ketones present, diabetic ketoacidosis

Answer 51

Hyperglycemia

Question 52

Hypokalemia and or hypochloremia

Answer 52

Suggests metabolic alkalosis

Question 53

Common with normal anion gap acidosis

Answer 53

Hyperchloremia

Question 54

Elevated creatinine and urea

Answer 54

Suggests uremic acidosis or hypovolemia (prerenal renal failure)

Question 55

Elevated creatinine

Answer 55

Consider ketoacidosis

Question 56

Consider ketoacidosis or hyperosmolar nonketotic syndrome

Answer 56

Elevated glucose

Question 57

Urine dipstick test for glucose and ketones

Answer 57

Glucose - hyperglycemia | Ketones - ketoacidosis