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ECCC Block 2 > Block 2 Unit 4- Arterial Blood Gas > Flashcards

Block 2 Unit 4- Arterial Blood Gas Flashcards

1
Q

What is an ABG?

A

An ABG is a blood test that measures the acid-base balance (pH) and the levels of oxygen (O2) and carbon dioxide (CO2) from an artery.

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2
Q

Newborn and Infants (0‐12 months old) will have the same normal values as adults. T or F?

A

False, Newborn and Infants (0‐12 months old) will have different normal values

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3
Q

What is the normal value for pH?

A

7.35-7.45

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4
Q

What is the normal value for PaO2?

A

80-100 mmHg

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5
Q

What is the normal value for PaCO2?

A

35-45mmHg

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6
Q

What is the normal value for HCO3?

A

22-26 mEq/L

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7
Q

What is the normal value for BE?

A

-2 to +2

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8
Q

What 2 body systems are responsible for controlling pH levels in the blood by regulating the acid-base balance?

A

respiratory and renal

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9
Q

How does the respiratory system maintains normal blood pH levels?

A

The respiratory system maintains normal blood pH levels by the regulation of carbondioxide (CO2‐) through exhalation.

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10
Q

When CO2‐ levels increase in the body, what does the respiratory system do to combat it and how?

A

the respiratory system changes breathing rates. By increasing or decreasing the respiratory rate, the lungs can regulate changes in blood pH levels within minutes.

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11
Q

How does the renal system assists with regulation of acid‐base balance?

A

The system assists with regulation of acid‐base balance through the excretion of hydrogenions (H+) in the urine and the return of bicarbonate (HCO3‐) to the blood.

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12
Q

What is Bicarbonate?

A

Bicarbonate is a base that acts as a buffer in the blood; CO2 and HCO3 work together to balance the pH.

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13
Q

How long does it take the body to make bicarbonate?

A

It can take several hours or even days for the renal system to regulate changes in blood pH levels.

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14
Q

If a patient’s pH is less than 7.35, the patient is in?

A

Acidosis

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15
Q

If the patient’s pH is more than 7.45, the patient is in?

A

alkalosis

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16
Q

Changes in the PaCO2 level reflect what?

A

lung function.

If the CO2 is high or low this means that the problem comes from a respiratory issue. If the CO2 is normal, then the problem is metabolic

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17
Q

the PaCO2 and pH are inversely related. T or F?

A

True

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18
Q

If the HCO3‐ is less than 22 mEq/L your patient
is in?

A

acidosis

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19
Q

If the HCO3‐ is greater than 26 mEq/L, then your patient is in?

A

alkalosis

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20
Q

What does ROME stand for?

A

stands for…
Respiratory Opposite, Metabolic, Equal.

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21
Q

If the HCO3- is normal, the PaCO2 value will be trending in the “opposite” direction of the pH‐ this will represent?

A

either respiratory acidosis/alkalosis

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22
Q

If the PaCO2 is normal, the HCO3- will be trending in the “equal” or same direction as the pH‐ this will represent?

A

either metabolic acidosis/alkalosis

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23
Q

The SaO2 is an important indicator of oxygenation. It is a direct measurement of oxygen that is attached to?

A

hemoglobin

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24
Q

If the PaO2 is less than __mmHg, or the SaO2 is less than__%, the patient has hypoxia

A

80, 95

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25
Q

the pH is not within or close to the normal ranges, this indicates?

A

a partial‐compensation

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26
Q

If the pH is back within normal ranges this indicates?

A

a full‐compensation

27
Q

A non‐compensated or uncompensated abnormality usually represents what?

A

an acute change occurring in the body;

28
Q

What is wrong with this patient?

A

They have Respiratory Acidosis

29
Q

In respiratory acidosis, the patient will have what?

A

a below normal pH (acidosis) and high PCO2 (Retention by the lungs).

30
Q

What are some of causes of respiratory acidosis?

A

• Hypoventilation
• Respiratory infection
• Severe airflow obstruction as in COPD or asthma
• Neuromuscular disorders
• Massive pulmonary edema
• Pneumothorax
• Central nervous depression
• Spinal cord injury
• Chest wall injury

31
Q

During respiratory acidosis, what happens to the kidneys?

A

They will be drowsy and disoriented because kidneys don’t work properly and cannot remove potassium from the body or if you take certain medicines. Which can cause lethal dysrythmias

32
Q

What happens with Metabolic Acidosis?

A

In metabolic acidosis, the patient is unable to get rid of acid or conserve base. The pH and HCO3‐ will both be below normal and trending the same way.

33
Q

What are some causes of metabolic acidosis?

A

Renal failure
Diabetic ketoacidosis (DKA)
Lactic acidosis
Sepsis
Shock
Diarrhea
Drugs and toxins such as Ethylene glycol & Methanol

34
Q

Metabolic acidosis causes hyperkalemia which results in what type of concentration that is elevated in relation to total body stores?

A

They will be hyperkalemia because, electroneutrality is maintained in part by the movement of intracellular potassium into the extracellular fluid.

Thus, metabolic acidosis results in a plasma potassium concentration that is elevated in relation to total body stores.

35
Q

Why will a patient have decreased LOC with metabolic acidosis?

A

They will have a change in level of consciousness (LOC) because the patient becomes dehydrated from the loss of fluid from the causes: DKA, diarrhea, or shock

36
Q

Why will a patient have decreased BP with metabolic acidosis?

A

They will be hypotensive because there is decreased cardiac output, arterial dilatation with hypotension, altered oxygen delivery to name a few causes.

37
Q

What happens during respiratory alkalosis?

A

the patient will lose CO2 from the lungs through hyperventilation with deep, rapid respirations.

This will cause a high pH and a low PaCO2 in the patient.

38
Q

What is wrong with this patient?

A

They have respiratory alkalosis

39
Q

What’s wrong with this patient?

A

They have metabolic acidosis

40
Q

What are some causes of respiratory alkalosis?

A

Causes of respiratory alkalosis include hyperventilation, pain, anxiety, early stages of pneumonia or pulmonary embolism (PE), hypoxia, brainstem injury, severe anemia, & excessive mechanical ventilation.

41
Q

What is wrong with this patient?

A

They have metabolic alkalosis

42
Q

What is metabolic alkalosis?

A

A decrease in acid or an increase in base will cause the metabolic alkalosis.

This will cause a high pH and a high HCO3‐ in the patient.

43
Q

What are some specific Sx of metabolic alkalosis?

A

This patient will be restless because of decreased LOC, dizziness and irritability

This patient will be tachycardic because from dehydration from severe vomiting and diuretics

44
Q

What are the Tx goals for Respiratory Acidosis?

A

improve ventilation through the use of bronchodilators, mechanical ventilation, administration of supplemental oxygen, suctioning

45
Q

What are the Tx goals for Respiratory Alkalosis?

A

slowing the breathing rate, treating anxiety (may need an anxiolytic), pain relief, breathing into a paper bag allows a patient to re‐ breathe CO2. Mechanical ventilation correction should be done by a Provider or Respiratory Therapist

46
Q

What are the Tx goals for Metabolic Acidosis?

A

treating diarrhea/vomiting with intravenous fluids or intravenous sodium bicarbonate, administer antibiotics for sepsis, and consider hemodialysis to reverse renal failure.

47
Q

What are the Tx goals for Metabolic Alkalosis?

A

replacing electrolytes for imbalances and replace fluids to treat dehydration.

48
Q

Lab values:
pH 7.56
paCo2 20
HCO3 20

A

respiratory alkalosis, partially compensated

49
Q

Lab values:
pH 7.23
paCo2 37
HCO3 18

A

metabolic acidosis, uncompensated

50
Q

Lab values:
pH 7.31
paCo2 34
HCO3 21

A

metabolic acidosis, partially compensated

51
Q

Lab values:
pH 7.50
paCo2 32
HCO3 24

A

respiratory alkalosis, uncompensated

52
Q

Lab values:
pH 7.46
paCo2 36
HCO3 32

A

metabolic alkalosis, uncompensated

53
Q

Lab values:
pH 7.52
paCo2 48
HCO3 28

A

metabolic alkalosis, partially compensated

54
Q

Lab values:
pH 7.25
paCo2 60
HCO3 27

A

respiratory acidosis partially compensated

55
Q

Lab values:
pH 7.55
paCo2 47
HCO3 30

A

metabolic alkalosis, partially compensated

56
Q

Lab values:
pH 7.20
paCo2 49
HCO3 25

A

respiratory acidosis, uncompensated

57
Q

Lab values:
pH 7.30
paCo2 36
HCO3 16

A

metabolic acidosis, uncompensated

58
Q

Lab values:
pH 7.41
paCo2 26
HCO3 17

A

respiratory alkalosis, fully compensated

59
Q

Lab values:
pH 7.39
paCo2 48
HCO3 28

A

respiratory acidosis, fully compensated

60
Q

Lab values:
pH 7.22
paCo2 49
HCO3 24

A

respiratory acidosis, uncompensated

61
Q

Lab values:
pH 7.37
paCo2 33
HCO3 17

A

metabolic acidosis, fully compensated

62
Q

Lab values:
pH 7.22
paCo2 49
HCO3 28

A

respiratory acidosis, partially compensated

63
Q

Lab values:
pH 7.42
paCo2 32
HCO3 18

A

respiratory alkalosis, fully compensated

ECCC Block 2 (4 decks)

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