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I&M for Anesthesia - Fall 2013 > Arterial Blood Gas > Flashcards

Arterial Blood Gas Flashcards

0
Q

Normal pH range

A

7.35-7.45

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1
Q

Arterial blood gas is an essential part of diagnosing and managing

A

Oxygenation status
Ventilation failure
Acid base balance

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2
Q

Normal PaO2 range

A

80-100 mmHg

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3
Q

Normal PaCO2 range

A

35-45 mmHg

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4
Q

Normal HCO3 range

A

22-26 mmol/L

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5
Q

Bicarbonate is a _________ value.

A

Calculated

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6
Q

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

A

Bicarbonate

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7
Q

Normal range of BE

A negative BE indicates a base

A

-2 to 2 mEq/L

Deficit in the blood

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8
Q

Normal SaO2

A

> 95%

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9
Q

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

A

40 nEq/L

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10
Q

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

A

An increase in [H+]

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11
Q

How much CO2 does the body produce daily?

A

15,000 mmol

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12
Q

How much nonvolatile acids does the body produce daily?

A

50-100 mEq nonvolatile acids

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13
Q

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

A

Lungs and kidneys

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14
Q

These two buffers work in pairs

A

carbonic acid and base bicarbonate

H2CO3 and NaHCO3

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15
Q

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

A

H2CO3

Increase or decrease the rate and depth of ventilation

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16
Q

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

A

1-3 min

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17
Q

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

A

Entraining HCO3

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18
Q

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

A

Hours to days

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19
Q

If decreased pH
Increased CO2
Decreased ventilation

A

Respiratory acidosis

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20
Q

What can cause respiratory acidosis

A 
CNS depression
Pleural disease
COPD/ARDS
Musculoskeletal disorders
Compensation for metabolic alkalosis
All of these can decrease ventilation
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21
Q

What is the difference between acute and chronic respiratory acidosis?

A

Acute - little kidney involvement

Chronic - renal compensation via synthesis and retention of HCO3

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22
Q

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

A

0.08

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23
Q

Retention of CO2 results in decreased

A

Chloride

Can lead to hypochloremia because the body wants to balance charges

24
Q

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

A

0.03

25
Q

If increased pH
Decreased CO2
Increased ventilation

A

Respiratory alkalosis

26
Q

What can cause respiratory alkalosis?

A 
Inter cerebral hemorrhage
Salicylate and progesterone drug usage
Anxiety, which decreases lung compliance
Cirrhosis of the liver
Sepsis
27
Q

What is the difference between acute and chronic respiratory alkalosis?

A

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

Chronic - HCO3 decreases by 4

28
Q

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

A

Reabsorption, ammonium

29
Q

If decreased pH

Decreased HCO3

A

Metabolic acidosis

30
Q

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

A

PCO2 = 1.5(HCO3) + 8 +/- 2

The degree of compensation for metabolic acidosis

31
Q

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

A

12-24 hours

32
Q

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

A

1.2 mmHg

33
Q

Causes of metabolic gap acidosis

A 
Methanol
Uremia
DKA
Paraldehyde
INH
Lactic acidosis
Ethylene glycol
Salicylate
34
Q

Causes of nongap metabolic acidosis

A 
Hyperalimentation
Acetazolamide
RTA (calculate urine anion gap)
Diarrhea
Pancreatic fistula
35
Q

If increased pH

Increased HCO3

A

Metabolic alkalosis

36
Q

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

A

0.7

37
Q

Metabolic alkalosis is caused by

A 
Vomiting
Diuretics
Chronic diarrhea
Hypokalemia
Renal failure
38
Q

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

A

Two or more

39
Q

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

A

Delta HCO3 = HCO3 + change in anion gap

> 24

40
Q

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

A

Primary

41
Q

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

A

Primary

42
Q

What level of Pao2 indicates hypoxemia?

A

< 80 mmHg

43
Q

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

A

Acute, chronic

44
Q

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

A

Base excess

45
Q

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

A

0.3 x body weight x BE

46
Q

Formula for anion gap

A

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

47
Q

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

A

False

48
Q

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

A

Partially compensated

49
Q

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

A

The lungs are acting as a buffer response

50
Q

Always strongly suggest a metabolic acidosis

A

High anion gap

51
Q

Ketones present, diabetic ketoacidosis

A

Hyperglycemia

52
Q

Hypokalemia and or hypochloremia

A

Suggests metabolic alkalosis

53
Q

Common with normal anion gap acidosis

A

Hyperchloremia

54
Q

Elevated creatinine and urea

A

Suggests uremic acidosis or hypovolemia (prerenal renal failure)

55
Q

Elevated creatinine

A

Consider ketoacidosis

56
Q

Consider ketoacidosis or hyperosmolar nonketotic syndrome

A

Elevated glucose

57
Q

Urine dipstick test for glucose and ketones

A

Glucose - hyperglycemia

Ketones - ketoacidosis

I&M for Anesthesia - Fall 2013 (13 decks)

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