Arterial Blood Gas (ABGs) Parameters

Question 1

What does the acronym ABG stand for?

Answer 1

Arterial Blood Gas

Question 2

What do ABGs tell us?

Answer 2

The acid - base status and arterial oxygenation status

Question 3

How is the blood obtained?

Answer 3

Arterial puncture [from peripheral arteries] and Indwelling catheter [arterial line, central line, or PA line]

Question 4

What is the most common and preferred artery to draw from?

Answer 4

Radial artery

Question 5

What test must you complete before drawing arterial blood?

Answer 5

Alan’s Test

Question 6

Define arterial puncture:

Answer 6

blood is drawn through a needle puncture from a peripheral artery

Question 7

Why is the radial artery preferred do draw from?

Answer 7

It has collateral circulation
its near the surface
easy to palpate
not close to large veins

Question 8

Other than an Allen’s test, what must you do before conducting an arterial puncture?

Answer 8

1. Communicate with the patient about the purpose of the procedure
2. Apply pressure for at least 5 min (or how ever long it takes)
3. Ice and ABG sample unless its going to be analyzed within more than 10 - 15 min.

Question 9

What DON’T you do before an arterial puncture?

Answer 9

1. Palpate too firmly [inhibits blood flow]
2. Reposition the needle without first withdrawing the tip to subcutaneous tissue
3. Leave bubbles in the ABG syringe
4. Fail to adequately heparinize a sample to prevent clotting

Question 10

What are the normal values for the anion gap?

Answer 10

8-16 (anything above 20 requires a further test to see why its high)

Question 11

What is going on in the body when there is a high anion gap?

Answer 11

Acidosis

Question 12

High anion gap levels can be due to what?

Answer 12

Lactic acidosis
DKA
Poisoning
Kidney failure

Question 13

What can low anion gap levels mean?

Answer 13

Hyponatremia and multiple myeloma

Question 14

Normal ABG Value for: pH

Answer 14

7.35 - 7.45

Question 15

Normal ABG Value for: PaCO2

Answer 15

35 - 45 mmHg

Question 16

Normal ABG Value for: HCO3

Answer 16

22 - 26 mEq / L

Question 17

Normal ABG Value for: PaO2

Answer 17

[greater than] > 80 mmHg

Question 18

Normal ABG Value for: BE / BD

Answer 18

+ - 2 mmol / L

Question 19

Normal ABG Value for: SaO2 [oxygen]

Answer 19

[greater than] > 95%

Question 20

What does a pulse oximeter measure?

Answer 20

The percentage of hemoglobin that is saturated with oxygen

Question 21

Acidosis Value for: pH

Answer 21

[less than] < 7.35

Question 22

Acidosis Value for: PaCO2

Answer 22

[greater than] > 45 mmHg

Question 23

Acidosis Value for: HCO3

Answer 23

[less than] < 22 mEq/ L

Question 24

Acidosis Value for: BD

Answer 24

[less than] < -2 mmol /L

Question 25

Alkalosis Value for: pH

Answer 25

[greater than] > 7.45

Question 26

Alkalosis Value for: PaCO2

Answer 26

{less than] 35 mmHg

Question 27

Alkalosis Value for: HCO3

Answer 27

[greater than] > 26 mEq /L

Question 28

Alkalosis Value for: BE

Answer 28

[greater than] > +2 mmol / L

Question 29

What is the cause of the abnormality?

Answer 29

Respiratory (lungs) Metabolic (kidneys) Combination

Question 30

What does the metabolic (kidneys) system compensate for?

Answer 30

Primary respiratory acid/base problems

Question 31

Define compensation:

Answer 31

The bodys attempt to maintain the pH within normal limits and return the balance of 1:20

Question 32

How long does it take metabolic (kidneys) compensation to return back to normal?

Answer 32

24 - 48 hrs

Question 33

What does the respiratory (lungs) system compensate for?

Answer 33

Primary metabolic acid/base problems

Question 34

How long does it take respiratory compensation to return back to normal?

Answer 34

A few minutes

Question 35

If the pH is normal, it the patient fully compensated?

Answer 35

Yes

Question 36

If the pH is NOT normal, the patient is __________.

Answer 36

Partially compensated

Question 37

Does the pH always reflect the side of the primary disorder?

Answer 37

Yes

Question 38

When nothing lines up what does it mean and how do you reevaluate?

Answer 38

Full compensation = nothing lines up | Reevaluate using 7.4 as the normal value

Question 39

List the causes of metabolic ACIDosis:

Answer 39

1. DKA 2. Diarrhea 3. Renal failure 4. Shock 5. Salicylate overdose 6. Sepsis

Question 40

List the signs and symptoms of metabolic acidosis:

Answer 40

``` Headache Decreases BP Hyperkalemia Muscle twitching Warm flushed skin Nausea Vomiting Changes in LOC ```

Question 41

List the signs and symptoms of respiratory acidosis:

Answer 41

``` Decreased BP w/ vasodilation Rapid shallow respirations Headache Hyperkalemia Muscle weakness Drowsiness Dizziness ```

Question 42

List the causes of metabolic alkalosis:

Answer 42

Loss of gastric secretions Overuse of antacids Potassium wasting diuretics

Question 43

List the causes of respiratory acidosis:

Answer 43

``` HYPOventilation may be related to: drug overdose chest trauma pulmonary edema airway obstruction COPD neuromuscular disorders ```

Question 44

List the causes of respiratory alkalosis:

Answer 44

``` HYPERventilation may be related to: anxiety high altitude pregnancy fever hypoxia excessive tidal volume in ventilated patients initial stage of pulmonary embolus ```

Question 45

If the CO2 is on the same side as the pH its related to________.

Answer 45

Respiratory

Question 46

If the HCO3 is on the same side as the pH its related to _______.

Answer 46

Metabolic

Question 47

If SaO2 or PaO2 is below 80 its ____________.

Answer 47

Hypoxia

Question 48

What is the effect of hyperventilation on the lungs?

Answer 48

Decrease in PaCO2 level - blowing off CO2 too much

Question 49

What could be an increase of carbonic acid?

Answer 49

Bradypnea (slow breathing) // you cant get rid of CO2 so it builds up in the lungs - you get ride of carbonic acid by normal breathing