Exam #3: ABG Flashcards
Before performing an ABG, what test should be done, and why?
Allen Test
- Draw from radial a. so must ensure good blood flow
What component of an ABG determines how well patient is oxygenated, but is NOT used in acid-base?
pO2
Primary respiratory issue involves…?
pCO2
Primary metabolic issue involves…?
HCO3
High pCO2 indicates? Low pCO2 indicates?
- HIGH (>45) = acidosis
- LOW (<35) = alkalosis
High HCO3 indicates? Low HCO3 indicates?
- HIGH (>26) = alkalosis
- LOW (<22) = acidosis
Lungs compensate for…?
Metabolic processes
Kidneys compensate for…?
Respiratory processes
What is an uncompensated state?
Primary defect in pCO2 or HCO3- WITHOUT change in other
What is a compensated state?
Primary defect in pCO2 or HCO3- WITH change in other (SAME DIRECTION)
How does partial compensation differ from full compensation?
- Partial: outside 7.35 and 7.45
- Full: between 7.35 and 7.45
Low pH, HIGH pCO2 and HIGH HCO3 indicates?
Respiratory acidosis
High pH, LOW pCO2 and LOW HCO3 indicates?
Respiratory alkalosis
Low pH, LOW pCO2 and LOW HCO3 indicates?
Metabolic acidosis
High pH, HIGH pCO2 and HIGH HCO3 indicates?
Metabolic alkalosis
Respiratory Acidosis is due to? What might cause this (3)?
HYPOventilation
- Lung disease, neuro disease, drug-induced (opioids)
Respiratory Alkalosis is due to? What might cause this (4)?
HYPERventilation
- Anxiety, fear, sepsis, high elevation
What type of acid-base disorder presents with hypercapnia?
Respiratory Acidosis
What is the treatment for Respiratory Acidosis?
BiPAP
- Treat underlying cause
What type of acid-base disorder presents with tachypnea, palpitations, lightheadedness?
Respiratory Alkalosis
What is the treatment for Respiratory Alkalosis?
Treat underlying cause
Metabolic Acidosis is due to (2)?
- Gain of H+
- Loss of HCO3
What is the normal anion gap range? What is considered an elevated anion gap?
Normal: 8-12
- ELEVATED: 12+
What might cause an elevated anion gap?
MUDPILES = acids gain
- Methanol
- Uremia
- DKA
- Propylene glycol
- Iron/INH
- Lactic acidosis/lactate
- Ethylene glycol
- Salicylate, Starvation
What might cause a non-anion gap?
Bicarbonate loss
- Diarrhea
What type of acid-base disorder presents with compensatory hyperventilation, hyperkalemia?
Metabolic Acidosis
What is the recommended treatment for Metabolic Acidosis?
Dialysis
Metabolic Alkalosis is due to (2)?
- Loss of H+
- Gain of HCO3
If Metabolic Alkalosis is being considered, what test should be performed?
URINE CHLORIDE
If urine chloride <20, is this responsive or unresponsive? What does this mean for volume?
Responsive
- Volume DEPLETION
If urine chloride 20+, is this responsive or unresponsive? What does this mean for volume?
Unresponsive
- Volume OVERLOAD
What type of acid-base disorder presents with reduced ventilation rate; arrhythmias, hypokalemia?
Metabolic Alkalosis
What type of of acid-base disorder presents with hyperkalemia?
Metabolic Acidosis
What type of of acid-base disorder presents with hypokalemia?
Metabolic Alkalosis
If an acid-base disorder is mixed, what does this mean for pCO2 and HCO3 levels?
pCO2 and HCO3- go in opposite directions
What are the four steps in evaluating an acid-base disorder?
- Examine pH
- Respiratory vs. Metabolic
- Assess for compensation
- Calculate Anion Gap IF Metabolic Acidosis (>12 = elevated anion gap)
Which acid-base disorder involves an anion gap?
Metabolic Acidosis
