TOPIC 3 - respiratory diagnostics and ABG's Flashcards
risk factors for respiratory acidosis
Neuromuscular disorders
CNS depression
Hypoventilation
Decreased respiratory rate
signs and symptoms of respiratory acidosis
Kussmaul breathing
Chest pain
Nausea /vomiting
Abdominal pain
General muscle weakness
interventions for respiratory acidosis
Bronchodilators
Assisted ventilation
Respiratory stimulants
risk factors for metabolic acidosis
Diabetic ketoacidosis
Lactic acidosis
Resp., renal, or heart failure
Diarrhea, laxatives
signs and symptoms of metabolic acidosis
Vertigo
Neuro changes
Dyspnea
Tachypnea
Hyperpnea
interventions for metabolic acidosis
Monitor vitals
Monitor respiratory status
Monitor blood gases
Correct cause
Give bicarbonate
risk factors for respiratory alkalosis
Extended periods of hyperventilation
Extreme anxiety
Fever
signs and symptoms of respiratory alkalosis
Lightheadedness
Agitation
interventions for respiratory alkalosis
Encourage patient to take slow deep breaths
Decrease patient anxiety
Monitor ABG
risk factors for metabolic alkalosis
Vomiting
NG suctioning
Hypokalemia
Excess antacids/bicarb
Steroids
signs and symptoms of metabolic alkalosis
Lightheaded; N/V
Confusion; stupor
Muscle twitching; tremors
Numbness/tingling face or extremities
Electrolyte imbalance, dysrhythmias
interventions for metabolic alkalosis
Monitor: Vitals, neuro status, I & O, ABGs,
Warn/teach about taking too many antacids
normal pH range
7.35-7.45
normal paCO2 range
35-45
normal HCO3 range
22-26
acidic vs basic values
below 7.35 pH - acidic
above 45 paCO2 - acidic
below 22 HCO3 - acidic
above 7.45 pH - basic
below 35 paCO2 - basic
above 26 HCO3 - basic
when pH is up and paCO2 is down
respiratory alkalosis
when pH is down and paCO2 is up
respiratory acidosis
when pH is up and HCO3 is up
metabolic alkalosis
when pH is down and HCO3 is down
metabolic acidosis
diagnostic studies for respiratory symptoms
-blood serum - Hgb, Hct, ABG’s
-pulse ox
-CO2 monitor (end tidal capnography)
-sputum studies for C&S - identify infecting organism, cell type, diagnosis, course for antibiotic treatment
-skin test - test for allergic reaction or TB exposure
radiology tests for respiratory system
chest x ray - AP and lateral view to diagnose and evaluate change in respiratory system
CT - diagnosis of lesion (done when x ray is difficult to detect)
MRI - diagnosis of lesions (when difficult to assess CT) and for distinguishing vascular vs nonvascular structures
ventilation perfusion - ventilation without perfusion would suggest pulmonary embolus, diminished or absent radioactivity = lack of perfusion or airflow
angiogram - visualize pulmonary vasculature and locate obstruction
PET - distinguish benign and malignant pulmonary nodules
CBC with diff
leukocytosis occurs in majority of patients with bacterial pneumonia
WBC is greater than 15000
ABGs obtained to assess for
hypoxemia (paO2 less than 80)
hypercapnia (paCO2 greater than 45)
acidosis (ph less than 7.35
death can occur in what kind of change in pH
below 6.9 or higher than 7.8
compensatory mechanisms
respiratory (CO2) and renal (metabolic) maintain homeostasis
COPD patients are more likely to display what kind of ABG imbalance
respiratory acidosis because of damage to alveoli, decreased oxygen, and higher circulating levels of CO2
people with impaired renal function are likely to display what kind of ABG imbalance
metabolic acidosis because of retaining metabolic waste products
retaining CO2 results in
respiratory acidosis
excreting CO2 results in
respiratory alkalosis
retaining HCO3 results in
metabolic alkalosis
excreting HCO3 results in
metabolic acidosis
causes of respiratory acidosis
Hypoventilation
Respiratory failure
Asthma attacks, COPD
Chest injury/trauma (broken ribs)
Pulmonary edema
Medications
Obstructive sleep apnea
causes of respiratory alkalosis
Hyperventilation
Hypoxemia from acute pulmonary disorders
Pain
Anxiety/Fear
Salicylate or Nicotine overdose
Increased metabolism (fever, high altitudes)
causes of metabolic acidosis
inadequate intake of calories
diabetes type 1
cardiac arrest
sepsis (lactic acid accumulation)
trauma
seizures
renal failure
severe diarrhea, laxative use
causes of metabolic alkalosis
Vomiting, gastric suction
Extracellular fluid deficit
Dehydration
Circulatory shock
Loop or thiazide diuretic use
Hypokalemia
Ingestion of baking soda (bicarbonate product)
