Step I - Internal Consistency Flashcards
What is internal consistency?
clinical picture should be in harmony with ABG. should be a mathematical relationship between pH, PaCO2 and HCO3
What should you be comparing when determining internal consistency?
- BE and HCO3 to metabolic trend
- standard HCO3 to TCO2
What is the rule of eights?
a method that predicts plasma bicarb
What is FIO2 - PaCO2 congruity?
PaCO2 should not exceed 130mmHg on room air
What is PaO2 - SaO2 congruity?
60mmHg/90% sat
What does it mean if the internal consistency is not plausible?
a mixed disorder may be present
What are the primary organ systems involved in acid-base balance?
- respiratory
- renal
How does chronic disease affect the body?
it can impair compensation
What are the causes of mixed metabolic and respiratory alkalemia?
- critically ill patients
- blood transfusion
- pregnancy
- severe liver disease and vomiting
More people in the ICU will ____ with respiratory alkalemia?
hyperventilate
What are the causes of mixed metabolic and respiratory acidemia?
- status asthmaticus and COPD
- cardiac arrest
- poisoning
- pulmonary edema
What is mixed metabolic acidosis?
- high AG acidosis and hyperchloremic acidosis
- mixed high AG acidosis
What are the causes of metabolic acidosis and respiratory alkalosis?
- salicylate poisoning
- liver disease
- sepsis
What are the causes of metabolic alkalosis and respiratory acidosis?
- COPD with diuretics
- theophylline
- steroids
