Exam 2 (ABG) Flashcards
Alkalemia is the excessive production of?
OH⁻ (in relation to hydrogen ions)
Bicarb enters and leaves the body via?
The proximal tubules
H⁺ is reabsorbed via?
The distal tubules & collecting ducts
CO₂ enters leaves the body via?
The lungs
If PaCO₂ & HCO₃⁻ change in the same direction then?
It’s a primary disorder with secondary compensation
If someone’s PaO₂ on room air is 75 then on 100% it should be?
375 - 500 (Factor of 5)
What are the consequences of acidosis on the CV system?
- Impaired contractility
- Decreased arterial BP
- Increased sensitivity to dysrhythmias
- Decreased response to catecholamines
- Decreased threshold for V-fib
At what pH does reduced catecholamine response happen?
At 7.1
What are the consequences of acidosis on the nervous system?
- Obtundation
- Coma
What are the consequences of acidosis on the pulmonary system?
- Hyperventilation
- Dyspnea
- Respiratory muscle fatigue
What are the consequences of acidosis on metabolism?
- Hyperkalemia
- Insulin resistance
- Inhibition of anaerobic glycolysis (decreased glucose production)
What is a flail chest?
Multiple broken ribs in various places
What are the 3 categories for respiratory acidosis?
- Central ventilation control (brain)
- Peripheral ventilation control (neuromuscular)
- V/Q mismatch (respiratory)
What happens to bicarb & PaCO₂ in acute hypercarbia?
- Bicarb rises slowly over 2-3 days
- PaCO₂ increases
What does a PaCO₂ to Bicarb ratio of 10 : 1 mean?
The kidneys are compensating
What would the PaCO₂ to Bicarb ratio be for chronic hypercarbia?
10 : 3
A Pt’s PaCO₂ is 80 mmHg, what is the expected HCO₃⁻?
28 mmHg
(PaCO₂ is 40 mm higher than normal; apply 10 : 1 rule; then HCO₃⁻ should increase 4 meq/L)
What happens to calcium in metabolic acidosis?
An increase in ionized calcium
A left shift of the oxyhemoglobin curve is associated with?
- Decreased PCO₂
- decreased H⁺
- decreased 2,3-DPG
- decreased temp
- HbF
A right shift of the oxyhemoglobin curve is associated with?
- Increased PCO₂
- Increased H⁺
- Increased 2,3-DPG
- Increased temp
If Bicarb is 12 mml/L then what is the expected PaCO₂?
- 26 mmHg
- 1.5 x 12 + 8= 26
- 1.5 x HCO₃⁻ + 8
Bicarb loss is compensated with?
A net gain of chloride ions
What are causes metabolic acidosis with a normal anion gap?
- Sodium chloride infusions
- Diarrhea
- Early renal failure
What are causes for metabolic acidosis with a high anion gap?
- Lactic- & Ketoacidosis
- Renal failure
- Poisonings
