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Nursing 231 - Exam 1 > EXAM 1 - ABGS > Flashcards

EXAM 1 - ABGS Flashcards

ABGS/Metabolic alterations

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1
Q

What is the normal range for pH?

A

7.35-7.45

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2
Q

what is the normal range for HCO3?

A

22-26 mEq/L

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3
Q

what is the normal range for sodium?

A

135-145 mEq/L

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4
Q

What is the normal Base to Acid ratio?

A

20:1

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5
Q

what metabolic alteration do COPD clients typically have?

A

Compensated Respiratory Acidosis - Cant expel carbon-dioxide as easily, but the kidneys help keep this compensated.

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6
Q

what is the slower response by the body to an acid-base imbalance?

A

Renal/Kidneys - responds in hours to days

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7
Q

What kind of breathing causes respiratory alkalosis?

A

Fast, Hyperventilation

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8
Q

What is the normal range for calcium?

A

8.5 to 10.5 mg/dL

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9
Q

twitching, muscle spasm, positive chvostek, tetany, convulsions are all S/S of what?

A

hypocalcemia

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10
Q

How do the Kidneys compensate for Respiratory Acidosis?

A

Retain HC03, Excrete H+

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11
Q

How do the lungs compensate for metabolic alkalosis?

A

Hypoventilation

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12
Q

what is the normal range for paO2?

A

80-100 mm Hg

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13
Q

How do you treat respiratory alkalosis?

A

Treat Underlying causes - Breathing techniques (to slow breathing), anxiolytics (like ativan)/sedatives

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14
Q

How do the lungs compensate for metabolic acidosis?

A

Hyperventilation/Kussmauls

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15
Q

What are some causes of Metabolic Acidosis?

A

DKA, Starvation, Lactic Acidosis, Prolonged Diarrhea, Renal failure, Asprin(salycilic acid)/Ethylene Glycol(glycolic acid)/alcohol, Cardiovascular failure

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16
Q

What are some signs and symptoms of Hyperkalemia?

A

Paralysis, confusion, stupor

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17
Q

What can be administered to a patient to help them eliminate potassium from their system?

A

Kayexelate (sodium polystyrene)

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18
Q

what is the normal range for saO2

A

95-100%

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19
Q

What electrolyte imbalance increases risk of digoxin toxicity? why?

A

hypokalemia. Digoxin binds more easily when potassium levels are low.

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20
Q

What drug can be used to take potassium from the ECF and into the cell?

A

Insulin Drip during hyperkalemia - watch for hypoglycemia and hypokalemia

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21
Q

What Drugs are the most common cause of hypokalemia?

A

K-wasting diuretics

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22
Q

What are some signs and symptoms of Metabolic Alkalosis?

A

Irritability (muscle and cardiac), Dysrhtymias (irregular rhythm), Twitching/cramps-tetany, Hypokalemia, Hypocalcemia (+cvostek,+trousseau)

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23
Q

How do the Lungs compensate for Respiratory Acidosis?

A

Hyperventilation

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24
Q

What happens to a clients EKG during hypokalemia?

A

Flat or inverted T-wave

25
Q

How do the Kidneys compensate for Respiratory alkalosis?

A

Excrete more Base and retain more Acid

26
Q

what is the normal range for chloride?

A

96-106 mEq/L

27
Q

What are some causes of respiratory Alkalosis?

A

Conditions causing Hyperventilation: Anxiety, Pain, fear, early pumonary embolism, Septicemia, Hypermetabolic states (fever), CNS stimulants (catacholamines such as epi, dopamine), Hypoxemia, overventilation, pregnancy (from progesterone)

28
Q

At what paO2 is supplemental oxygen required? What can oxygen for a hypoxic patient prevent?

A

50 mmHg/ an acid-base imbalance

29
Q

How do you treat metabolic Acidosis?

A

Treat underlying causes: (Insulin + K+-this keeps patient from becoming hypokalemic from insulin), Sodium Bicarbonate, IV fluids

30
Q

what is the normal range for PaCO2?

A

35-45 mm Hg

31
Q

What are some signs and symptoms of Metabolic Acidosis?

A

Compensatory Kussmaul breathing (rapid, deep), Dysrythmias, Hyporeflexia, weakness, N/V, Stupor-coma, Hyperkalemia, Hypercalcemia

32
Q

What kind of Breathing can cause respiratory acidosis?

A

Low and slow, hypoventilation

33
Q

How do you treat respiratory acidosis?

A

Underlying causes - Bringing p/t breathing back to normal so they are getting more oxygen and expelling more Co2. bronchodialators, O2, steroids, overdose reversal agents, mucolytic

34
Q

pH is below 7.35, PaCO2 is above 45, HCO3 is within range. How would you identify these labs?

A

uncompensated respiratory acidosis

35
Q

What are some precautions you can take for hypocalcemia?

A

seizure precuations - e.g. padded side rails

36
Q

What kind of Drugs cause respiratory acidosis? why?

A

CNS depressants - Alcohol, opioids, benzos - because the slow breathing.

37
Q

Agitation, restlessness, Lightheaded, dizzy, Parastheisa, Seizures, Hypokalemia, Hypocalcemia—These are signs and symptoms of what?

A

Respiratory Alkalosis

38
Q

What is the immediate action that should be taken after puncturing an artery to retrieve ABGs?

A

hold pressure on site for 5 minutes

39
Q

How do you treat Metabolic Alkalosis?

A

Underlying causes: potassium chloride (increases potassium), ammonium chloride (fixes metabolic alkalosis in two ways: It’s broken down into urea by the liver, resulting in the liberation of H+ and Cl- ions. The increase in H+ ions acidifies the body. The increase Cl- ions promotes HCO3- excretion), antiemetics (stop from vomitting and losing more acid)

40
Q

what % of oxygen is dissolved in the blood and what % is bound to hemoglobin?

A

3% dissolved - 97% oxyhemoglobin

41
Q

What are some signs and symptoms of respiratory acidosis?

A

dyspnea (SOB), Depressed respirations, Headache, drowsiness, Tachycardia, Flushed warm skin, Weakness, Confusion

42
Q

What does a T- wave represent on an ECG?

A

ventricular repolarization (decrease of pressure in the ventricles)

43
Q

how do you perform an Allen test?

A

Have patient clench fist - occlude both ulnar and radial arteries- have patient relax hand and check for blanching - release finger from ulnar artery- if the hand flushes in 5 to 15 seconds, test is positive and ulnar artery is patent- If the hand does not flush, test is negative, ulnar artery is not patent, meaning radial artery cannot be punctured.

44
Q

What are two routes of administration of calcium for hypocalcemia?

A

Po an IM

45
Q

How is potassium Administered? What precautions should be taken?

A

Potassium is given orally or Slow IV infusion ( over 4 hours. Most bags hold 40 mEq/L and you usually run it at 10 mEq/L) . NEVER iv push. Wait until urine flow is established post-op and careful with people who have esophogeal issues.

46
Q

As blood pH becomes more acidic, what happens to Hemoglobin and temperature?

A

gives up O2 more easily, temperature rises

47
Q

How do the lungs compensate for respiratory alkalosis?

A

Hypoventilation

48
Q

Term for low oxygen content in the blood?

A

hypoxemia

49
Q

Characterizedd by a deep, rapid breathing pattern

A

Kussmaul Respirations

50
Q

How do the kidneys compnesate for metabolic alkalosis?

A

Retain Acid and Excrete Base

51
Q

What is the normal Anion gap range?

A

8-12

52
Q

What would an EKG look like for hyperkalemia?

A

Possible Tented T-waves

53
Q

what are the catastrophic pH numbers that will cause death?

A

Below 6.8 or Above 7.8

54
Q

What is the rapid response by the body to an Acid-Base imbalance?

A

Respiratory/Lungs - responds in minutes

55
Q

How do the Kidneys compensate for metabolic acidosis?

A

Excrete Acid and retain Base

56
Q

what is a sign of hypokalemia? how serious is this?

A

Muscle weakness, including the diaphragm. This is life threatening.

57
Q

What are some causes of metabolic alkalosis?

A

Vomitting, Gastric suctioning, Excessive bicarb or antacids, Kwasting diuretics, Massive blood transfusion

58
Q

What electrolyte imbalances/labs will you see with respiratory acidosis?

A

Hyperkalemia (tented-t waves), Hypercalcemia, Decreased PAO2 (not getting enough oxygen)

Nursing 231 - Exam 1 (8 decks)

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