blood gases Flashcards
ventilation
paco2
oxygenation
pao2 and cao2
to evaluate how a patient is responding to a therapeutic intervetion
oxygen therapy, bipap,
mechanical ventilation
determine the need for arterial puncture
ventilation assessment?
oxygenation assesment?
assess factor that influence bag measurement
anxiety- decrease paco2 ETT suction Pao2 svn pao2 derangement change in o2 therapy /ventilator settings positioning of the patient body temperature /metabolic rate changes in RR
what do the anticoagulation effect on ABG taking
it will increase the time needed for direct pressure
watch for?
review for patients allergy history
determine history of any surgery like radial artery for coronary artery bypass surgery and fistula
patient preparation
verify patient
ensure that the patient and family understand pre procedural teaching
allow at 20-30 minutes
position the patient appropriately
radial artery is best because
should be first surface of choice close to surface of skin not too close to skin easy stabilize passes over a bony grove located at the wrist small needle size 23-25 gauge
disadvantage
increase risk of arterial spasm and pain
must hold 5 minutes
brachial site for arterial puncture
second choice readily palpable artery spasm less common extension of axillary artery in upper 1.5 inches above antecubital need size 21-23 gauge
femoral site
largest artery of three needle 16-18 disadvantages is location being less accessible hematoma may be less evident presence of vein and nerve laying along side of artery plaque is dislodge infection and limb ischemia must hold 10-15 min
common complication from arterial puncture
infection
hematoma related to improper technique or patient underlying condition
peripheral nerve damage related to improper technique
thrombus , related to improper technique and can result is ischemia
pain, related to invasive procedure and tolerance
modified alleys test
asses collateral circulation in the patient hands via the ulnar artery
clotting
use pre-heparinized syringe
excessive heparin in sample
minimized with heparin bake or ball
excess heparin lowers and the ph and paco2
remember the paco2 will always___________ with air bubbles?
decrease
what to look for _______ ?
temperature
steady state or you should wait?
20 to 30 min
