Arterial Blood Gases Flashcards
ABGs are a
great tool when concerned about resp probs - tell how ventilating and oxygenating, pH, PCO2, HCO2, PO2, base excess
Arterial blood pH
PCO2, HCO2, PO2 - base excess; PO2 - 80-100 - amount O2 flowing in the arterial sys
See if acid-base in balance when interpret ABGs; body wants to keep us in balance; out balance body tries to fix; acid-base world prob in resp sys - metabolic sys/kidneys try to fix to get pH back to norm; metabolic sys - resp sys try to fix it to get back into balance; body will try to start compensating for that abnormality - depends on when catch it
Norm pH - 7.35-7.45; midpoint 7.4
Less than 7.35 = acidic/acidosis
Above 7.45 = basic/alkalosis
Pa02:
80-100 mm Hg
pH:
7.35-7.45
PaCO2:
(partial pressure of carbon dioxide)
35-45 mm Hg – the respiratory component - controlled by the lungs
HC03:
(bicarbonate)
22-26 mEq/L – the metabolic component - controlled by the kidneys; either hold on/get rid of bases to try to balance it; kidneys work lot slower than; longer fix respiratory abnormality than metabolic since they have fix resp
Causes of acidosis
starvation/malnutrition, shock, burns, kidney failure, acute MI = decrease pH and HCO3
Hypoventilation results in respiratory acidosis decreases pH and increases CO2 from drug overdose causes pulm edema leading to chest trauma and neuromuscular disease to COPD then to airway obstruction
COPD (emphysema & chronic bronchitis) obesity, asthma, pneumonia, anesthesia effects, use of opioids, severe head injury; Drug influence: Narcotics & sedatives
Respiratory acidosis
Results when respiratory function is impaired and causes retention of CO2
CO2 increases and pH down; CO2 acid and more acid more acidodic become
Due to resp failure - not breathing in and out not getting CO2 and starts increasing and pH starts to go down and more acid have more acidic become
Treatment -
Treatment - (Respiratory acidosis)
focused on improving ventilation and oxygenation and maintaining a patent airway; resp depression due to opioids - narcan; emphysema and pneumonia - BiPAP/intubate - may have to ventilate for them
Metabolic acidosis
State of excess acid (number 1 excess acid is diabetic ketoacidosis - break down fats and proteins instead of carbs produce ketone bodys that are acids and increased acids in metabolic sys and causes this) or reduced base bicarbonate in the body
Treatment -
Treatment - (Metabolic acidosis)
focused on hydration and drugs or treatments to control the problem causing the acidosis; IV Sodium Bicarbonate is administered only if serum bicarbonate levels are low; reverse that; insulin - diabetic ketoacidosis; not enough bicarbonate because kidneys not filtering right give it
Causes of alkalosis
Increases pH and decreases CO2
Hyperventilation from anxiety from high altitudes or pregnancy, fever -> hypoxia -> initial stages of pulmonary emboli
Hysteria, nervousness, strenuous phys exertion, rapid breathing
Increases pH and increases HCO3
Metabolic alkalosis: loss gastric juices, K wasting diuretics (increased loss of H+), overuse of antacids
Severe vomiting, peptic ulcer, K loss (as in diuretic therapy), hepatic failure, cystic fibrosis, excess admin of bicarbonate
Resp alkalosis
Caused by an excessive loss of CO2 through hyperventilation - tingly, anxious, lot pain, breathing too fast and getting rid too much CO2
pH greater than 7.45; kidneys have to hold onto too much acids
Treatment -
Treatment - (Resp alkalosis)
correct the underlying cause; if due to hyperventilation/anxiety or panic attack - instruct the patient to take slow, deep breaths or breathe into a brown paper bag; rebreathe that CO2 - one best ways to do that
Metabolic alkalosis
Caused by either an increase ingestion of bases (base excess) or a decrease of getting rid acids (acid deficit)
Lot vomiting; NG tube - lot NG suctioning because sucking all acids out
Treatment -
