Blood Chemistry Testing Flashcards

1
Q

Purpose of testing blood gasses

A

Evaluate fxn of:

  • Lungs
  • Kidney
  • Blood
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2
Q

What are the arterial blood gases? (7)

A
pH
PaCO2
PaO2
SaO2
HCO3
O2CT
Total C02
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3
Q

pH

A
pH = [H+] in blood
Negative log (10x as much b/w levels)
Tight range for blood = 7.35-7.45
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4
Q

PaC02

A

partial pressure of C02
Low = NORMAL –> 35-45mm Hg
High = poor blood ventilation

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5
Q

Pa02

A

partial pressure of 02
HIGH in arterial (oxygenated) blood = 80-100mm Hg
Ability of lung to oxygenate blood

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6
Q

Sa02

A

saturation level of blood
% of carrying capacity of blood if all hemoglobin was saturated
94-100%

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7
Q

HCO3

A

crucial for maintenance of blood pH = kidneys job to control concentration
22-26 mEq/L

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8
Q

O2CT

A

Actual amount of 02 in blood

15-23%

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9
Q

Low Pa02 with 02CT, and

Sa02 with high PaC02

A

Not getting 02 into lungs

muscle weakness, airway obstruction, resp center obstruction

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10
Q

DECREASE in: Pa02, 02CT, Sa02

Normal PaC02

A

Insufficient oxygenation of the blood

pneumothorax, septal defect, interstitial fibrosis

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11
Q

LOW 02CT

Normal: Pa02, Sa02, PaC02

A

Severe anemia

blood cant carry 02 or decreased blood volume (ie: bleeding)

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12
Q

Total Carbon Dioxide

A

end of metabolism: CO2 flows out of RBC and dissolves in plasma as carbonic acid

measures all forms of C02 in plasma (most = HCO3)

Normal: 22-26 mEq/L

Test = acid base balancing ability

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13
Q

What are some electrolytes? (7)

A
Na
K
Mg
PO3 (phosphate)
Ca
Cl
Anion Gap
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14
Q

Na = SODIUM

A

extracellular cation that maintains osmotic P

Controls body fluid level, membrane depolarization, acid base balance, regulates Cl and K

NORMAL: 135-145 mEq/L

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15
Q

[Na} and water

A
decrease = more water lost
increase = more water absorbed
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16
Q

Hypernatremia

A

too much Na

  • Dehydration
  • Water loss exceeding Na loss: (Diabetes Insip, Kidney failure, vomit/diarrhea)
  • Increase retention: primary ALD, increased intake
17
Q

Hyponatremia

A

too little Na

  • Inadequate intake (rare)
  • Excessive Na loss: sweating, vomit/diarrhea, adrenal insuf, burns, chronic kidney disease)
18
Q

K = POTASSIUM

A

intracellular cation

repolarizes membranes

Disturbance = altered cardiac rhythms, neural impulse transmission, muscle contraction

NORMAL = 3.5-5 mEq/L (most IN the cells)

19
Q

Hyperkalemia

A

too much K

  • Diet
  • Intra to extra cellular shift
  • renal failure
  • MI
  • insulin def / ketoacidosis
20
Q

Hypokalemia

A

too little K

  • Vomit/Diarrhea
  • Diuretic use
  • too much ALD produced
  • GI / renal issue
  • insulin injection w/o supplementation
21
Q

Magnesium Mg

A

Crucial for enzymatic activation for DNA synthesis (nucleic acids + proteins)

Co-transports K & Na; Influences PTH and Ca = Most in BONE

NORMAL = 1.3-2.1 mg/dl

HIGH = renal failure...addisons disease  
LOW =  alcoholism, HPT, diuretics, ALDism, pancreaitis
22
Q

P03 = PHOSPHATE

A

store / utilize ATP

Ca regulator, Bone formation, RBC production

NORMAL = 2.7-4.5 mg/dl

23
Q

Hypophosphatemia

A

too little

Malnutrition, HPT, will suppress child growth

24
Q

Hyperphosphatemia

A

too much

Skeletal disease (acromegaly via tumor in pituitary)
Healing fx
hypoparathyroidism

25
Ca = CALCIUM
1% BODY TOTAL IN BLOOD 40% ionized, 50% bound --- ionized = 8:1g ratio w/ serum albumin NORMAL: - total = 8.2-10.2 mg/dl - ionized = 4.65-5.28mg/dl
26
Hypercalcemia
too much HPT, Pagets, MM, Mets, Fx
27
Hypocalcemia
too little Hypoparathyroidism, Malabsorption, excessive loss (Cushings)
28
Cl = CHLORIDE
w/ Na to maintain osmotic P regulates blood vol/P Absorbed in intestines, Kidneys excrete NORMAL = 100-108 mEq/L --- inversely related to HC03
29
Hyperchloremia
too much Severe dehydration (dehydration), hyperventilation
30
Hypochloremia
too little Assoc w/ low Na + K levels Vomiting, addisons
31
Anion Gap
- reflects anion cation balance - tests: Na + Cl + HCO3 - serum should be neutral Na = 90% cation Cl + PO3 = 85% anion NORMAL = 8-14 mEq/L
32
Normal Gap Acidosis
Loss of HC03 Renal absorption of Na & Cl increases Gap remains constant but HCO3 buffer is lost
33
High Gap Acidosis
Measured by increase in anions Due to accumulation of metabolic acids (renal failure, ketoacidosis [starvation, DM, alcohol]