Arterial Blood Gases Flashcards
ABG Components: PH
Measures the balance of acid and base in the blood, amount of free H+ ions
ABG Components: PaO2
Measures the partial pressure of oxygen in arterial blood
ABG Components: PaCO2
Measures the partial pressure of carbon dioxide in arterial blood
Increased levels lead to more acidic blood
Decreased levels lead to more basic blood
ABG Components: HCO3 (Bicarb)
Calculated concentration of bicarbonate in arterial blood
* Elevated amounts lead to more basic blood
* Decreased levels lead to more acidic blood
ABG Components: SaO2
Calculated arterial oxygen sat
Allen Test
- Used to assess the blood flow through the radial and ulnar arteries that supply the blood flow to the hands.
- this is done to ensure that when an arterial blood draw is performed that the hand receives adequate perfusion
- Performed by occluding both arteries, with the patient making a fist, and releasing one to see how well it perfuses, repeat for the the other artery
- Normal is perfusion is returned under 15 seconds
*
Negative allen test
- Perfusion takes longer than 15 seconds to occur
- Indicates the pt likely does not have adequate dual blood supply
- Probably shouldn’t do an art stick
Complication of Arterial puncture
- Hematoma
- Art occlusion
- Air embolism
Complication of Arterial puncture: Hematoma, arterial occlusion
- Hematoma forms when blood accumulates under the skin at the site
Nursing actions
1. 5 p’s: Observe for changes in temp, edema, color, loss of pain or pulse
2. Notify provider immediately if any of these occur
3. Apply pressure to hematoma
How long should you apply pressure after an arterial puncture
~5min but longer
Complication of Arterial puncture: Air embolism
Air gets in during cath insertion
Nursing actions
1. Place the pt flat or in trendelenburg
2. Ask the pt to bear down while holding their breath (Valsalva maneuver), like poopin
3. Monitor for sudden onset of shortness of breath, hypoxia, chest pain or air hunger
4. Notify the provider immediately, admin o2, and obtain abg, continue to monitor pt
Normal PH
Know this
7.35-7.45
Normal CO2
Know this
35-45
Normal pO2
80-100
Normal HCO3
Know this
22-26
Normal O2 sat
95-100
Diabetic acidosis
Probably dont need to know
- DKA: Not enough insulin, body digest fats building ketones making your blood acidic
- Metabolic acidosis
Metabolic acidosis
Hyperchloremic acidosis
Probably dont need to know
Loss of bicarb, diarrhea and vomiting
Metabolic acidosis
Lactic acidosis
Probably dont need to know
Caused by
1. Chronic alc use
2. HF
3. Seizures
4. Liver failure
5. Prolonged lack of O2
6. Sepsis
Metabolic acidosis
Renal tubular acidosis
Probably dont need to know
occurs when the kidneys are unable to excrete acids in the urine
Metabolic acidosis
Causes of metabolic alkalosis
- Use of diuretics and the external loss of gastric secretions
- Excessive vomiting which causes electrolyte loss
- Vomiting hypokalemia, overdosage of bicarb and NGT suctioning are considered to be risks
- Antacids
- Laxatives
- alc abuse
Causes of resp acidosis
- COPD
- Asthma
- Diseases of the lung (Pulmonary fibrosis)
- Muscular or nerve diseases
- Obesity
- Sleep apnea
- Thoracic skeletal defects that limit breathing
- Organ failure
- Shock
- Coma
- Severe dmg to the kidneys
- Seizures
- Intracranial pressure
Causes of resp alkalosis
- Anxiety or panic (Hypervent)
- Fever
- Hyper vent
- Pain
- Trauma
- Severe anemia
- Liver disease
- Central nervous system abnormalities
- Overdose of certain meds
- Any lung disease that leads to SOB (Pulmonary embolism and asthma)
Interpertation of ABG: 3 questions
- Acidosis/Alkalosis
- Metabolic/Respiratory
- Compensated/ Uncompensated/ partially compensated
