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Patient Assessment > Blood Gas Interpretation > Flashcards

Blood Gas Interpretation Flashcards

1
Q

Oxygenation

A

Is defined through PaO2 and SaO2 or more specifically CaO2 which will also look at Hb

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2
Q

CaO2

A

CaO2 is that total content of oxygen in the body

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3
Q

CaO2 Formula

A

(1.34HbSaO2)+(0.0031*PaO2)
Where 1.34 is the saturation capacity
0.0031 is your solubility coefficient

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4
Q

DO2

A

The delivery of oxygen to the tissues

DO2=CaO2 x CO (cardiac Output)

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5
Q

Oxygenation Determined Through

A

Spontaneous Breathing: (FiO2)

Positive Pressure Ventilation: (FiO2 and Mean Airway Pressure)

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6
Q

SaO2 and PaO2

A

Oxygen Dissociation Curve

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7
Q

Ventilation

A

Separate from oxygenation
Defined by PaCO2 and pH
Determined by
Alveolar minute ventilation= (RR x VT)

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8
Q

pH Normal Range

A

7.35-7.45

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9
Q

pH Goal Range

A

7.35-7.45

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10
Q

PaCO2 Normal Range

A

35-45 mmHg

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11
Q

PaCO2 Goal Range

A

35-45 mmHg

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12
Q

PaO2 Normal Range

A

80-100 mmHg

Partial Pressure of oxygen

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13
Q

PaO2 Goal Range

A

Greater than or equal to 60 mmHg

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14
Q

HCO3 Goal Range

A

22-26

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15
Q

Bases Excess

A

+/- 2

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16
Q

SaO2 Normal Range

A

95-100%
Should be very close to SpO2 (peripheral oxygen saturation)
Oxygen saturation in hemoglobin

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17
Q

SaO2 Goal Range

A

Greater than 90

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18
Q

Normoxemia

A

PaO2 80-100 mmHg

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19
Q

Mild Hypoxemia

A

PaO2 60-79 mmHg

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20
Q

Moderate Hypoxemia

A

PaO2 40-59 mmHg

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21
Q

Severe Hypoxemia

A

PaO2 less than 40 mmHg

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22
Q

Hyperoxemia

A

Oxygen in high levels which can be toxic

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23
Q

Hydrolysis Equation

A

CO2 + H2O H2CO3 HCO3- + H+
As CO2 production increases the bicarbonate will naturally increase as well
Do not confuse this with compensation

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24
Q

PaCO2 and HCO3

A

Acute changes in PaCO2 will cause a fairly immediate For every 10 mmHg increase in PaCO2 there is a 1 mmol/L increase in HCO3
For every 10 mmHg decrease in PaCO2 there is a 2 mmol/L decrease in HCO3

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25
Q

Acid Base Disorders

A

Metabolic (Non-Respirtory)

Respiratory (Ventilation)

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26
Q

Respiratory Acid Base Disorders

A

A normal PaCO2 will be 35-45 mmHg
< 35 will cause pH to increase/alkalemia
>45 will cause pH to decrease/academia
If PaCO2 is abnormal and in the opposite direction of pH then it is the primary cause

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27
Q

Respiratory Acid Base Disorders

A

A normal HCO3 will be 22-26 mmol/L
< 22 will cause pH to decrease/academia
>26 will cause pH to increase/alkalemia
If HCO3 is abnormal and in the same direction of pH then it is the primary cause

28
Q

Henderson-Hasselbalch Equation

A

Relationship between metabolic and respiratory acid base disorder

29
Q

For every 10 mmHg increase in PaCO2 there is a _______ increase/decrease in pH

A

For every 10 mmHg increase in PaCO2 there is a corresponding decrease in pH by 0.06

30
Q

For every 10 mmHg decrease in PaCO2 there is a _______ increase/decrease in pH

A

For every 10 mmHg decrease in PaCO2 there is a corresponding increase in pH by 0.10

31
Q

Base Excess

A

Change in the total blood buffer base above or below normal

32
Q

Base Excess and HCO3

A

The total quantity of buffer anions in the blood is approximately twice that of HCO3
HCO3 accounts for only about half of the total buffering capacity of the blood, which means that BE will provide a more complete picture of blood buffering
Acute changes in PaCO2 will not affect BE
This is why BE is considered to be a pure measure of metabolic components of the acid base balance

33
Q

A positive BE

A

Excess base or excessive loss of acid

34
Q

Negative BE

A

Excessive Acid or Excessive loss of Base

35
Q

Acidemia

36
Q

Alkalemia

37
Q

pH= 7.35-7.45:

A

Normal
Fully compensated disorder
Mixed disorder

38
Q

Compensation

A

Compensation will occur as the body tries to maintain a normal (or closer to normal) pH
The body does not over compensate

39
Q

Compensation in Respiratory Disorders

A

The metabolic system compensates by either increasing or decreasing the HCO3- levels to “correct” the pH back to normal
This occurs in the kidneys through the excretion/retention of bicarbonate
Full compensation may take several days
While this results in both HCO3- and PaCO2 levels being abnormal it brings the pH back to (or closer to) normal

40
Q

Compensation in Metabolic Disorders

A

The respiratory system responds by either increasing or decreasing minute volume resulting in a decrease or increase in PaCO2
The new PaCO2 will counteracts the metabolic problem and “corrects” the pH, resulting in both PaCO2 and HCO3 being abnormal but the end result is a pH that is normal or closer to normal

41
Q

Predicted pH

A

If PaCO2 = 40: Predicted pH should = Measured pH

42
Q

Predicted pH when PaCO2 > 40

A

Predicted pH = 7.40 – [(PaCO2 – 40) * .006]

43
Q

Predicted pH when PaCO2 < 40

A

Predicted pH = 7.40 + [(40 - PaCO2)* .01]

44
Q

Co-Oximetry

A

Will should hemoglobin levels and types

45
Q

Types of Hemoglobin

A 
Normal
Methemoglobin
Carboxyhemoglobin
Sulfhemoglobin
Fetal hemoglobin
46
Q

Methemoglobin

A

Fe+++ reduced Hb carrying capacity

47
Q

Carboxyhemoglobin

A

Up to 8% in cities

Half life of 4-6 hours in room air, as low as 35min without HBOT

48
Q

Sulfhemoglobin

A

Sulfur atom blocks heme (drugs)

49
Q

Fetal hemoglobin

A

Curve shift left

50
Q

Normal Hemoglobin

51
Q

Uncompensated (Acute) Respiratory Acidosis

A

PaCO2 is high, causing a low pH

HCO3 is normal

52
Q

Partially Compensated Respiratory Acidosis

A

PaCO2 is high, causing a low pH (not as low as expected for a high PaCO2
HCO3 is high in an attempt to being pH back to normal range (but has not yet done this)

53
Q

Fully Compensated (Chronic) Respiratory Acidosis

A

pH is within normal range

PaCO2 and HCO3 is high

54
Q

Uncompensated (Acute) Respiratory Alkalosis

A

PaCO2 is low, causing a high pH

HCO3 is normal

55
Q

Partially Compensated Respiratory Alkalosis

A

PaCO2 is low, causing a high pH

HCO3 is low in an attempt to being pH back to normal range (but has not yet done this)

56
Q

Fully Compensated (Chronic) Respiratory Acidosis

A

pH is within normal range

PaCO2 and HCO3 is low

57
Q

Uncompensated (Acute) Metabolic Acidosis

A

HCO3 is low, causing a low pH

PaCO2 is normal

58
Q

Partially Compensated Metabolic Acidosis

A

HCO3 is low, causing a low pH

PaCO2 is low in an attempt to being pH back to normal range (but has not yet done this)

59
Q

Fully Compensated (Chronic) Metabolic Acidosis

A

pH is within normal range

PaCO2 and HCO3 is low

60
Q

Uncompensated (Acute) Metabolic Alkalosis

A

HCO3 is high, causing a high pH

PaCO2 is normal

61
Q

Partially Compensated Metabolic Alkalosis

A

HCO3 is high, causing a high pH

PaCO2 is high in an attempt to being pH back to normal range (but has not yet done this)

62
Q

Fully Compensated (Chronic) Metabolic Alkalosis

A

pH is within normal range

PaCO2 and HCO3 is high

63
Q

Uncompensated (Acute) Metabolic Acidosis

A

HCO3 is low causing a low pH

PaCO2 is normal

64
Q

Partially Compensated Metabolic Acidosis

A

HCO3 is low causing a low pH

PaCO2 is low

65
Q

Fully Compensated (Chronic) Metabolic Acidosis

A

pH is within normal range

PaCO2 and HCO3 is low

66
Q

Combined Respiratory and Metabolic Acidosis

A

pH is low and both PaCO2 and HCO3 are contributing to this

High PaCO2 and a low HCO3

67
Q

Combined Respiratory and Metabolic Alkalosis

A

pH is high and both PaCO2 and HCO3 are contributing to this

Low PaCO2 and a high HCO3

Patient Assessment (5 decks)

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