exam Flashcards
Reason to for obtaining blood gases
- to determine the acid base state of the patient
2. to determine how well oxygen
Parameters in ABG
PCO2: respiratory influences
HCO3: metabolic
Amperometic measurements
pO2, Glucose, Lactate
penetentiometeric
pH, pCO2, Na+, K+, Ca++, Cl,
- ISE
Hemoglobin
visual
Derived measurements
Total CO2
Base excess
Specimen Requirements for ABG/VBG
arterial or venous blood
- pulsator syringe
- peds abg
- dry heparin syringe
- 15 min room temp
- 30 min ice
Whole Blood profile
- dry heparin syringe
- rt 15 mins
Capillary gas
AVL microsampler
- 30 min rt no ice
CO OX
Sodium heparin vacutainer - sodium heparin microtainer -Anerobic pulsator syringe - specimen handling -- 15 min rt -- 30 min ice COHgb: roomtemp or 2-8 for 5 days
ICAL
dry heparin syringe
- AVL microsampler device 1 hr rt or 6 hr on ice
Allens test
test performed to ensure that the hand has viable blood flow if damage to artery is damaged
Blood gas inaccuracy
sending venous sample and calling it an arterial blood
- Po2 less than 65 and o2 saturation less than 80
mechanisms for compensation of resiratory Acidosis/ alkalosis
acidosis: (pCO2 is increased) increase the bicarb by the kidneys excreting more acid and less bicarb
alkalosis: (pCO2 decreased) decrease the bicarb: excreting less acid and more bicarb
mechanisms for compensation of metabolic
acidosis: ( decreased bicarb) decrease the PCO2 by hyperventilation
alkalosis: ( increased bicarb) increase the PCO2 by hypOventilation
disease associated with Respiratory acidosis
- sedative overdose
- pulmonary embolism
Diseases associated with Respiratory alkalosis
- CNS pain
- anxiety and panic disorder
- hypoxemia
Disease associated with metabolic acidosis
- lactic acidosis
- ketoacidosis
- diarrea or intestinal losses
diseases associated with metabolic alkalosis
- Vomiting/nasogastric suction
- massive diuresis
- hypokalemia
right shift of hemoglobin affinity
increased: temp, pCO2, 2-3 DPG
decreased PH
- decreased affinity
left shift hemoglobin affinity
increased: pH
decrease temp, PCO2, 2-3 dpg
- increased affinity
hypoxia
decreased oxygen
- involves SO2 and PO2
parameters measured in CO OX
optical absorbance of sample that measures hemoglobin and it derivatives
What does a CO OX measure
- total hemoglobin
- Oxyhemoglobin
- deoxyhemoglobin
- methemoglobin
- carboxyhemoglobin
abnormal results
- methemoglobin - cytochrome b5 deficiency
- carbonmonoxide posioning
Clinical used for an uring osmolgap
increased output: primary polydipsia-> compulsion to drink water
diabetes insipidis and mellitus
decreased output: dehydration, acute tubular injury
Clinical used for a serum osmol gap
- screening toxins: alcohols and glycols
- monitoring osmolitacally active agents: mannitol
- evaluating hypanatremia: exclusion of pseudo hypanatremia amd pressure of other osmostic agens
Calcuating serum osmolity
2 X NA + (glu/18)+(BUN/2.8)
normal between 280 and 300
osmol gap
the difference between the measured and calculated ions
- MUDPILES
- -methanol
- -uremia
- diabetes
- parahylde
- isopropanol
- lactate
- ethanol
- salicylates
FFN
fetal fibrinectin
- if negative less than 1% chance of giving birth in the next 14 days
TEG
evaluates coagulation and clot formation of bllod
R time
time it takes for the initial fibrin formation
- checks plasma
K
speed at which the clot reaches a certain level of strength
alpha
measures the rapidity of fibrin buildip and crosslinking strength
- measures cryoprecipitate
MA
strength of the clot
- checks the platelets
Ly30
clot lysis
- drugs tranexamic/ amicar
