Arterial Blood Gases Flashcards
How do you determine if compensation is occurring?
BOTH pCO2 and HCO3 will be either decreased or increased
What makes an ABG acidotic?
pH below 7.35
What makes an ABG alkalotic?
pH above 7.45
How do you determine if an ABG is fully compensated?
pH is normal, but will always lean to side of abnormality, never midpoint unless is a normal ABG
How do you determine if an ABG is partially compensated?
pH is abnormal
How do you evaluate oxygenation status?
O2 sat; if below 90=hypoxemia. And pCO2
Why does compensation occur?
To restore normal pH and maintain homeostasis
Respiratory compensation takes how long to occur?
W/in minutes
Metabolic compensation takes how long to occur?
24hrs or more
How do you determine if uncompensation is occurring?
pCO2 and HCO3 are going in opposite directions
If an ABG is acidotic how will you know if it’s respiratory?
pCO2 will go up
If an ABG is acidotic how will you know if it’s metabolic?
HCO3 will go down
If an ABG is alkalotic how will you know if it’s respiratory?
pCO2 will go down
If an ABG is alkalotic how will you know if it’s metabolic?
HCO3 will go up
What are risk factors for metabolic acidosis?
Diarrhea, intestinal suctioning, abd fistulas, DM
Clinical manifestations for metabolic acidosis?
Weakness, fatigue, HA, general malaise, diminished appetite, N/V, abd pain, kussmaul breathing, SOB/dyspnea
Declined LOC can decline into stupor/coma
Cardiac dysrhythmias can develop cardiac arrest
What are Kussmaul respiration’s?
Deep and rapid respiration’s
What are the electrolyte imbalances w/ metabolic acidosis?
Hyperchloremia, increased potassium and calcium, decreased Mg
How do you treat metabolic acidosis?
Alkalinizing solutions like sodium bicarbonate, lactate, citrate and acetate
What is the safety alert as metabolic acidosis is being corrected?
Monitor potassium levels bc hypokalemia and cardiac dysrhythmias can occur from potassium shifting back into intracellular space
What are risk factors for metabolic alkalosis?
Hospitalization, hypokalemia, and treatment w/ alkalizing solutions
Clinical manifestations for metabolic alkalosis?
Numbness/tingling around mouth/fingers/toes, dizziness, Trousseau’s sign, muscle spasms, depressed respirations
What is Trousseau sign?
A spasm of the hand and forearm
What are the electrolyte imbalances w/ metabolic alkalosis?
Hypocalcemia, decreased potassium/chloride
How do you treat metabolic alkalosis?
Restoring normal fluid volume and admin. potassium chloride and sodium chloride
What are risk factors for respiratory acidosis?
Lung diseases or trauma (pneumonia, COPD), airway obstruction, narcotic analgesics, neuromuscular diseases
How does acute respiratory acidosis result?
Sudden failure of ventilation (hypoventilation)
How does chronic respiratory acidosis result?
Chronic respiratory or neuromuscular conditions that effect alveolar ventilation
Clinical manifestations for acute respiratory acidosis?
HA, blurred vision, irritability, mental cloudiness, progressive decrease of LOC
Clinical manifestations for chronic respiratory acidosis?
Weakness, dull HA, sleep disturbances, daytime sleepiness, impaired memory and personality changes
What is a safety alert for pt’s w/ chronic respiratory acidosis?
Monitor neuro and resp. status who are receiving O2 therapy and immediately report any changes
What are the electrolyte imbalances w/ respiratory acidosis?
Hypochloremia in chronic
How do you treat respiratory acidosis?
Bronchodilators and antibiotics, respiratory support: supplemental O2, intubation, mechanical ventilators
What are risk factors for respiratory alkalosis?
Anxiety w/ hyperventilation, critically ill pt’s on mechanical ventilation
Clinical manifestations for acute respiratory alkalosis?
Light-headedness, feeling of panic or difficulty concentrating, paresthesia’s, tremors, Chvostek sign, Trousseau sign, tinnitus, chest tightness, palpations and possible seizures and loss of consciousness
What is the Chvostek sign?
Type of facial spasm usually indicating hypocalcemia
What are the electrolyte imbalances w/ respiratory alkalosis?
Hypocalcemia
How do you treat respiratory alkalosis?
A sedative or antianxiety, respiratory support: using a brown paper bag (may cause hypoxia though), breathing exercises
What are normal pH levels?
7.35-7.45
What are normal bicarbonate levels?
24-28
What are normal pCO2 levels?
35-45
What are pO2 levels?
80-100