ICU Equipment

Question 1

Define anion gap.

Answer 1

Unmeasured anions in the blood e.g. ketones, uric acid, ethylene glycol

Question 2

What are the normal blood gas ranges?

Answer 2

pH = 7.35-7.45
PaO2 = 80-100mmHg
PaCO2 = 35-45mmHg
HCO3 = 21-24
Base excess = +2 - -2mEq
Anion gap (dogs) = 12-24mEq/L
Anion gap (cats) = 13-27mEq/L

Question 3

Describe metabolic acidosis.

Answer 3

pH <7.35
Can be caused by increase in lactate
Compensation = pH within normal limits but HCO3 very low and PaCO2 also low

Question 4

Describe metabolic alkalosis.

Answer 4

pH >7.45
Compensation = pH within normal limits but HCO3 very high and PaCO2 also high

Question 5

Describe respiratory acidosis.

Answer 5

PaCO2 >45mmHg
Body will hyperventilate to get rid of CO2

Question 6

Describe respiratory alkalosis.

Answer 6

PaCO2 <35mmHg
Body will hypoventilate to retain CO2 to bring pH down

Question 7

What can cause metabolic acidosis?

Answer 7

Diarrhoea
Diabetic ketoacidosis
Renal failure
Addison’s disease
Lactic acidosis (sepsis)

Question 8

What can cause metabolic alkalosis?

Answer 8

Vomiting (loss of H+ ions)
Hypoalbuminaemia (weak acid)
Upper GI obstruction (vomiting)

Question 9

What nursing considerations should we have for ventilator patients?

Answer 9

Eye/mouth care
Airways, humidification
Physio and positioning
Lines, drains, tubes
Urination/defaecation
Drugs
Treatment of underlying disease
Communication, record-keeping
Acid-base, blood gas and electrolytes