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Therapeutics IV Final Subjects > Arterial blood Gases > Flashcards

Arterial blood Gases Flashcards

1
Q

With the hinderson Hasselback equation simplified, H is proportional to ____ / _____ which means that if CO2 goes down, what must hapen to HCO3 compensitority

A

PCO2 / HCO3;

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2
Q

What is the normal pH of the blood?

A

7.36 to 7.44

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3
Q

What is the normal level of HCO3

A

22-26 mEq/L

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4
Q

What is the normal level of PCO2

A

36-44 mmHg

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5
Q

PCO2 represents the __________ component

A

respiratory

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6
Q

HCO3 represents the ______ and ______ components

A

metabolic and chemical

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7
Q

What controls the respiration rate due to regulation?

A

carotid cehmoreceptors

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8
Q

What does the chemoreceptors cause you to do if you have too high of H concentration

A

breather faster

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9
Q

What system is important for the nonvolitile acids and the volitile acids?

A

Renal; Lungs

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10
Q

What happens in the kidneys if there is too high a H concentration in the blood?

A

the kidneys will hold onto HCO3 to offset the inc of H in the blood from CO2

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11
Q

What are the three forms of regulation in the body and what three substances make up the non dominant one?

A

Respiratory, Metabolic and chemical; phosphate, protein, hemoglobin (for chemical)

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12
Q

What is the difference between acidosis and acidemia?

A

acidosis is the predisposition to getting acidemia but is not yet having acidemia

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13
Q

What does the term mixed mean?

A

more than one type of acid-base abnormality

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14
Q

respiratory acid-base disorders are compensated by

A

metabolic mechanisms

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15
Q

metabolic acid-base disorders are compensated by

A

respiratory mechanism

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16
Q

How long does it take the respiratory compensation to take effect and how long for full effect?

A

30mins, 12-24 hrs

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17
Q

how long does it itake the metabolic compenstation to take effect and how long for full effect?

A

6-12h, 3-5 days

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18
Q

How many equations are there? Why are there not 8?

A

due to the fast compensation for the respiratory system, when there is a metabolic acidosis or alkilosis there is no acute or chronic reaction from the lungs; its always fast.

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19
Q

What do the following numbers mean? 7.32/40/18/26

A

pH/PaCO2/PaO2/HCO3

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20
Q

What is SaO2 and BE?

A

oxygen saturation and base excess

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21
Q

what are the two types u cant have together?

A

respiratory alkilosis and respiatory acidosis

22
Q

If pH is opposite of PaCO2 then what type of acid-base disorder is it? What about if HCO3 is opposite?

A

respiratory; respiratory

23
Q

What is the normal values for PaCO2 and HCO3?

A

36-44; 22-28

24
Q

How do you tell what type of mix they have using > or < HCO3 and > or < PaCO2

A

Metabolic: >PaCO2 - respiratory acidosis
HCO3 - metabolic alkalosis
<HCO3 - metabolic acidosis

25
Q

what is the anion gap equation? what is normal anion gap? What are some unmeasured anions and cations?

A

anion gap = Na - (Cl + HCO3); 12; albumin, phosphate, organic anions; K, Ca, Mg

26
Q

So which acid-base disorder can be spit up into high anion gap and non-anion gap?

A

metabolic acidosis

27
Q

What is the anion gap equation?

A

change anion gap / change HCO3

28
Q

A normal delta anion gap/delta HCO3 is ____

A

1

29
Q

What does it mean if the ratio is less than 1?

A

its concurrent non-anion gap metabolic acidosis

30
Q

What does it mean if the ratio is more than 1?

A

its concurrent metabolic alkalosis

31
Q

So for high anion gap metabolic acidosis it could be 3 things:

A

with non anion-gap metabolic acidosis if the ratio is less than 1; with metabolic alkalosis if the ratio is greater than one; or normal (where it equals 1)

32
Q

What is normal PaO2?

A

80-100

33
Q

What is normal SaO2?

A

> 95%

34
Q

What is normal BE?

A

-2 - 2 mEq/L

35
Q

What does less than -2 mean?

A

metabolic acidosis

36
Q

What does more than 2 mean?

A

metabolic alkilosis

37
Q

What are some adverse events of Acidemia?

A

CV, hyperventilation,

38
Q

What are some causes of Respiratory acidosis?

A

not being able to expel CO2 - so like airway obstruction, COPD, asthma, brain injury

39
Q

What is therapy for respiratory acidosis?

A

tx underlying cause, avoid sedatives, consider alkali therapy in severe cases

40
Q

What are some causes of metabolic acidosis?

A

High anion gap caused by MUD PILES
Non-anion gap - diarrhea, renal tubular acidosis, carbonic anhydrase inhibitors (topiramate), renal insufficiency, mineralocorticoid deficiency

41
Q

what does mud piles refer to and what does it stand for?

A 
Drugs that induce metabolic acidosis:
Methanol
Uremia
Diabetic ketoacidosis (can be metabolized)
Propylene glyco
Iron/isoniazid
Lactate
Ethylene glycol
salicylates
42
Q

how do you treat metabolic acidosis?

A

tx underlying cause; avoid caustive agents; avoid metformin, nitroprusside and NRTI, consider alkali therapy in severe cases or based on underlying cause

43
Q

What are the 5 drugs for alkali therapy?

A

Na Bicarb, Na acetate, Na citrate, Na lactate, Tromethamine

44
Q

Why does Tromethamine have advantages?

A

It doesn’t have Na and it doesnt regenerate CO2

45
Q

What are some side effects of alkalemia?

A

CV, hypoventilation

46
Q

What are some causes of respiratory alkalosis?

A

hyperventiation (anxiety, fever, pain, pregnanacy, lung disease, etc)

47
Q

What is the tx for respiratory alkalosis?

A

tx underlying cause, avoid causative agents, consider rebreathing in symptomatic cases

48
Q

What are some causes of metabolic alkalosis?

A

vomiting, gastric aspiration, loop or thiazide diuretics, posthypercania, hyperaldosteronism, corticosteroids, licorice, alkali ingestions, exchange resin and antacids, penicillin, hypercalcemia, hypomagnesemia, hypokalemia

49
Q

How do you tx metabolic alkalosis?

A

tx underlying cause, avoid caustive agents, consider hypdrochloric acid in severe cases

50
Q

Excessive vomiting is most likely to cause?

A

metabolic alkilosis

Therapeutics IV Final Subjects (10 decks)

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